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Multiple system atrophy
Alternate Names : Shy-Drager syndrome, Neurologic orthostatic hypotension, Shy-McGee-Drager syndrome, Parkinson's plus syndrome
Symptoms & Signs
MSA damages the nervous system, which can cause the following symptoms: - Changes in facial expression
- "Mask" appearance to face
- May be unable to close mouth
- Reduced ability to show facial expressions
- Staring
- Difficulty chewing or swallowing (occasionally)
- Disrupted sleep patterns (especially during rapid eye movement (REM) sleep late at night)
- Dizziness or fainting when standing up or after standing still
- Frequent falls
- Impotence
- Loss of control over bowels or bladder
- Loss of fine motor skills
- Difficulty eating
- Difficulty with any activity that requires small movements
- Writing that is small and hard to read
- Loss of sweating in any part of the body
- Mild decline in mental function (may occur)
- Movement difficulties
- Muscle aches and pains (myalgia)
- Muscle rigidity
- Difficulty bending arms or legs
- Stiffness
- Nausea and problems with digestion
- Posture difficulties: may be unstable, stooped, or slumped over
- Slow movements
- Difficulty beginning to walk or starting any voluntary movement
- Freezing of movement when the movement is stopped, unable to start moving again
- Small steps followed by the need to run to keep balance
- Tremors
- May become severe enough to interfere with activities
- May be worse when tired, excited, or stressed
- May occur at rest or at any time
- May occur with any action, such as holding a cup or other eating utensils
- Finger-thumb rubbing (pill rolling tremor)
- Vision changes, decreased or blurred vision
- Voice and speech changes
Other symptoms that may occur with this disease:
Diagnosis & Tests
The health care provider may perform the following: - Blood pressure measurement, lying and standing
- Eye examination
- Nerve and muscle (neuromuscular) examination
There are no specific tests to confirm this disease. A neurologist can make the diagnosis based on: - History of symptoms
- Findings during a physical examination
- Ruling out other causes of symptoms
Testing to help confirm the diagnosis may include:
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Review Date : 10/30/2008
Reviewed By : David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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