MSA Symptoms

Multiple system atrophy (MSA) affects multiple parts of the body and signs of the disease usually begin appearing when people are in their 50s. It is associated with deterioration and shrinkage of the parts of the brain that regulate internal body functions, digestion, and motor control. There’s no known cause for these brain changes. The symptoms are similar to those of Parkinson’s disease, but advance much more rapidly.

MSA falls into one of two categories: Parkinsonian (MSA-P), or cerebellar ataxia (MSA-C). Which classification is diagnosed depends on which types of motor symptoms are most prominent when the initial evaluation is performed.


The primary motor symptoms resemble Parkinson disease and include:

  • Rigidity
  • Low-volume speech
  • Slow movements
  • Tremor (usually mild)
  • Slow or “shuffling” walk leading to falls


The primary motor symptoms of MSA-C resemble ataxia (lack of coordination) and include:

  • Limb incoordination
  • Unsteady gait and loss of balance causing falls
  • Slurred speech
  • Visual disturbances, such as blurred or double vision and difficulty focusing the eyes

Additional Symptoms

In addition to impairment in mobility, all patients with MSA-P or MSA-C have autonomic dysfunction that can vary in its degree of severity from patient to patient. In fact, movement problems may present much later than autonomic problems in MSA, which include:

  • A feeling of fainting or lightheadedness when standing; caused by orthostatic hypotension, a condition in which blood pressure drops when rising from a seated or prone position
  • Urinary frequency (urgency or retention), constipation, and in men, impotence
  • Abnormal sweating. Less sweat, tears, and saliva are produced and control of body temperature is impaired, often causing cold hands or feet, as well as heat intolerance

Other MSA-related symptoms include:

  • Sleep disorders, including sleep apnea and a tendency to act out dreams
  • Dystonia, which is an abnormal posture of limbs or the neck
  • Vocal cord impairment causing stridor
  • Swallowing and chewing difficulty

Request an Appointment

To schedule an appointment with a multiple system atrophy specialist at UT Southwestern’s facilities in Dallas, or to learn more about our services, request an appointment or call 214-645-8300.