Multisystem atrophy (MSA) Home A-Z Health Information Health Library A-Z Multisystem Atrophy (MSA) Overview Multisystem atrophy is a progressive neurodegenerative disease, which affects the autonomic system and the motor system. Causes MSA is caused due to deposition of abnormal synuclein protein (synucleinopathy) in the brain. Risk factors Genetic variations in certain genes including SNCA and LRRK2Age group: 50-60 yearsMale sexHistory of neurological conditions such as Parkinson's diseaseVascular risk factors including hypertension, diabetes mellitus, hyperlipidaemia,Exposure to solvents, certain types of plastic or metal, and other potential toxinsRapid eye movement (REM) sleep behaviour disorderAutonomic nervous system conditions Symptoms Autonomic disturbances such as postural hypotension and urinary incontinenceParkinsonian signs such as bradykinesia and rigidityCerebellar signs such as ataxia and inability to coordinatePyramidal signs such as weakness and spasticityMyoclonic jerksSleep disorders such as sleep apnoea, REM behavioural disorders, excessive daytime sleepiness, and nocturnal sleep disturbancesRespiratory complications such as stridorDysphagia at later stagesCognitive disability in later stages Specialist to approach Neurologist Diagnosis Clinical history and examinationMRI Brain to determine hot cross bun sign in brain stem.Polysomnography to check for sleep disordersAutonomic nervous testing Treatment No specific treatment is available.Supportive care for prevention of orthostatic hypotension, sleep disorders, dysphagia, stridor, and parkinsonian symptoms