I have a new patient diagnosed with Multiple System Atrophy (MSA), a rare progressive neurodegenerative condition affecting the body’s involuntary (autonomic) functions, including blood pressure, breathing, bladder function, and motor control. MSA is a synucleinopathy with over-expression of alpha-synuclein in both neurons and glial cells, including oligodendrocytes which produce myelin; it also affects several areas of the brain including the cerebellum, affecting balance and coordination, as well as the autonomic nervous center. Balance does seem to be a predominant symptom, although I have yet to officially consult with this patient so don’t have enough clinical info yet to know what type of MSA this would be classified as – Parkinsonian or Cerebellar.
Despite the poor prognosis, I’m rather optimistic (especially after the most recent mastermind) that we have some potential therapeutic options that may be of benefit – at the very least to slow the course. The patient very much has the financial resources and means for whatever treatment may potentially pose some benefit as far as slowing, or if possible, reversing the course. While I have a general idea of how to approach this patient, I’d love to hear if anyone has experience with this condition and any additional input or treatment recommendations! Thanks!!
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