MSA - A Lesson

I haven't done any information sharing in my blog lately. So today will be a lesson in MSA/Shy-Drager.

When Dennis was first diagnosed with Shy-Drager, he was recruited by Mayo Clinic, in Rochester for a study. After the tests were completed, the doctors concluded that Dennis did not have MSA/Shy-Drager and encouraged us to see another neurologist, a movement disorder specialist. This neurologist said that Dennis did indeed have MSA, but instead MSA - P. Here is a brief description of the differences between the two as well as a 3rd type of MSA.

When autonomic failure predominates, MSA is sometimes termed Shy-Drager syndrome. When extrapyramidal features predominate, the term striatonigral degeneration, parkinsonian variant, or MSA-P is sometimes used. When cerebellar features predominate, MSA is sometimes termed sporadic olivopontocerebellar atrophy or MSA-C.

In plain English, this means that MSA has 3 different forms, each with a different group of symptoms predominating. Dennis has the type that looks like Parkinson's. Most MSA patients have the type where the autonomic systems deteriorate first. (Autonomic systems are those that your brain automatically controls - blood pressure changes, sweating, etc). The last type is identified by a gross lack of coordination.

The diagnosis of MSA, MSA - P, or MSA - C is given when the main symptom plus at least one other symptom is apparent in a patient. In MSA - P, Dennis' type, the main symptom is gait disorder. He has that plus 4 out of 5 of the other symptoms. The only symptom he does not display on a regular basis is tremors. In addition, he has one or two symptoms of each of the other types of MSA.

If you, or someone you give care to, has MSA, I would be curious what type of MSA you believe is the correct diagnosis.

Until later,
Ann and Dennis