Multisystem atrophy is a rare neurological disorder characterized by neurodegenerative processes of the brain. Atrophy causes abnormalities and disorders in the areas of the brain responsible for balance and movement, as well as in the autonomic nervous system that controls breathing, digestion, pelvic organ function, and blood pressure. The disease usually manifests over the age of 50, with the diagnosis occurring 1.5-2 times more often in men than in women.
Main symptoms and signs of multisystem atrophy
- Movement disorders. They occur in the initial stage of the disease in 60% of patients. Slowness of movement, characteristic shuffling gait with wide stance of the feet and small steps, tremor of the hands are noted. These signs are similar to Parkinson’s disease.
- Vegetative symptomatology. At the initial stage of the disease is manifested in 40% of patients. Complaints include postural hypotension (sudden, up to fainting, drop in blood pressure when moving to an upright position), sweating disorders, sleep disorders, sexual dysfunction, and disorders of excretory control (urinary or fecal incontinence).
There are 2 types of multisystem atrophy:
- Parkinsonian
- Cerebellar
Parkinsonian type of multisystem atrophy
This is the most common type of multisystem atrophy. Signs are similar to the symptoms of Parkinson’s disease, such as:
- Rigid muscles
- Difficulty bending arms and legs
- Bradykinesia
- Tremor that may occur at rest or when moving arms and legs
- High voice
- Problems with posture and balance.
Cerebellar type multisystem atrophy
The main symptoms are problems with muscle coordination, but there may be other symptoms as well:
- Movement and coordination impairment, such as unsteady gait and loss of balance
- Dysarthria
- Visual disturbances, such as blurred or double vision, difficulty focusing your gaze
- Difficulty swallowing and chewing
- Changes in speech.
Diagnosis
When diagnosing multisystem atrophy, it is necessary to differentiate this disease from other neurodegenerative pathologies, in particular, Parkinson’s disease, multiple sclerosis, tumors. The diagnosis is made on the basis of the following examinations:
- Clinical examination. The disorders characteristic of Parkinson’s disease in combination with additional symptoms (autonomic, cerebellar) are noted.
- MRI. At the initial stage, MRI diagnosis may not be indicative, since the picture is often normal. Atrophic changes in the cerebellum and subcortical ganglia are visualized at later stages. However, MRI allows you to exclude other pathologies: brain tumors, multiple sclerosis, etc.
- Examination of the autonomic system. To detect disorders, an orthostatic test, electromyography, etc. are performed.
Complications
Progression of multisystem atrophy occurs in a variety of ways, but the condition does not go into remission. As the disorder progresses, daily activities of daily living become more difficult.
Treatment
Treatment for multisystem atrophy is aimed at alleviating symptoms, as there are no drugs that can stop the progression of the disease. The main methods include:
1. Medication treatment:
- Medications to improve motor function, such as to reduce rigidity or tremor.
- Medications to correct autonomic disorders such as hypotension, urinary problems, and sweating.
2. Rehabilitation:
- Physical therapy to maintain mobility and balance.
- Speech therapy to improve speech and swallowing.
- Occupational therapy to increase independence in activities of daily living.
3. Assistive devices:
- Crutches, scooters and wheelchairs to improve mobility and prevent falls.
4. Psychological Support:
- Help from psychologists and support groups to combat depression and anxiety.
5. Correction of comorbidities:
- Treating conditions such as infections or breathing problems to prevent complications.
The approach to the management of multisystem atrophy is strictly individualized, emphasizing comfort and maintaining maximum independence.
Conclusion
Multisystem atrophy is a severe neurological disease that causes progressive disorders of motor and autonomic functions, which significantly impairs patients’ quality of life. Although there are no effective treatments to slow the progression of the disease, modern therapies and rehabilitation techniques can significantly alleviate symptoms and improve patient comfort. It is important that treatment be individualized, focused on maintaining maximum independence, improving functional capacity, and controlling complications. Timely diagnosis, a comprehensive approach to treatment and patient support at all stages of the disease can help improve the quality of life of patients.
