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First symptoms in multiple system atrophy.

Jake H McKay1, William P Cheshire2

  • 1Department of Neurology, Mayo Clinic, 4500 San Pablo Rd., Jacksonville, FL, 32224, USA.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|January 10, 2018
PubMed
Summary
This summary is machine-generated.

Early symptoms of multiple system atrophy (MSA) are often autonomic, particularly erectile dysfunction in men, preceding motor signs. Recognizing these initial autonomic signs can aid in earlier diagnosis of this neurodegenerative disorder.

Keywords:
Autonomic nervous system diseasesEarly diagnosisMultiple system atrophySymptom assessment

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Area of Science:

  • Neurology
  • Autonomic Dysfunction
  • Neurodegenerative Disorders

Background:

  • Motor symptoms are typically emphasized in diagnosing multiple system atrophy (MSA).
  • Early autonomic symptoms in MSA are often overlooked or ambiguous.
  • Identifying the earliest signs is crucial for timely diagnosis of neurodegenerative conditions.

Purpose of the Study:

  • To identify the very earliest symptoms in the natural history of multiple system atrophy (MSA).
  • To investigate the diagnostic significance of early autonomic versus motor symptoms in MSA.

Main Methods:

  • Observational study involving 30 recently diagnosed MSA subjects.
  • Detailed clinical histories focusing on early symptom onset were collected.
  • Data were correlated with neurological exams and laboratory autonomic testing.

Main Results:

  • Autonomic symptoms were the first presenting sign in 73% of MSA patients, compared to 10% for motor symptoms.
  • Erectile failure was the most frequent initial symptom in men, appearing years before diagnosis.
  • Other common early symptoms included postural lightheadedness, fatigue, urinary issues, and REM sleep behavior disorder.

Conclusions:

  • The initial symptoms of multiple system atrophy (MSA) are frequently autonomic and can precede motor manifestations.
  • Erectile failure and orthostatic hypotension are key early indicators.
  • Evaluating these early autonomic signs alongside other clinical findings can facilitate earlier and more accurate MSA diagnosis.