Two Types of MSA: MSA-P and MSA-C
The two primary types of Multiple System Atrophy are MSA-C (Cerebellar) and MSA-P (Parkinsonian). Learn more about the different types of MSA below.
What is MSA?
Before diving into the specifics of MSA-P and MSA-C, it’s essential to understand what Multiple System Atrophy entails. MSA is characterized by the gradual loss of nerve cells in various parts of the brain and spinal cord. This degeneration affects the body’s ability to control movement and autonomic functions, such as blood pressure, heart rate, and digestion. MSA is often misdiagnosed as Parkinson’s disease or other neurodegenerative disorders, making awareness and accurate diagnosis crucial.
Understanding the Two Types of MSA: MSA-C and MSA-P
Multiple System Atrophy (MSA) is a rare and complex neurodegenerative disorder that affects the autonomic nervous system and motor control. It is crucial to understand the different forms of MSA to effectively manage and support individuals living with this condition. The two primary types of MSA are MSA-P (Parkinsonian) and MSA-C (Cerebellar). While they share some similarities, they have distinct characteristics, symptoms, and progression patterns. We will dive into the differences between MSA-P and MSA-C, helping you gain a clearer understanding of these conditions.
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MSA-P (Parkinsonian Type)
SYMPTOMS:
MSA-P, also known as Parkinsonian MSA, shares many symptoms with Parkinson’s disease.
The key symptoms include:
- Tremors: While less common than in Parkinson’s disease, tremors can occur, typically in
the hands and fingers. - Bradykinesia: Slowness of movement, making simple tasks difficult and time-consuming.
- Rigidity: Muscle stiffness that can affect any part of the body, leading to a limited range
of motion. - Postural Instability: Difficulty maintaining balance, increasing the risk of falls.
pROGRESSION:
MSA-P tends to progress rapidly compared to Parkinson’s disease. Patients often experience a swift decline in motor functions, which can lead to severe disability within a few years of onset. The disease’s progression varies among individuals, but the loss of autonomic functions is a significant concern, contributing to symptoms like blood pressure irregularities, urinary incontinence, and erectile dysfunction.
Diagnosis:
Diagnosing MSA-P involves a combination of clinical evaluation, medical history, and diagnostic tests. Neurologists may use brain imaging techniques, such as MRI or DAT scans, and autonomic function tests to rule out other conditions and confirm the diagnosis.
MSA-C (Cerebellar Type)
SYMPTOMS:
MSA-C, or Cerebellar MSA, primarily affects the cerebellum, the part of the brain responsible for
coordination and balance. The main symptoms include:
- Ataxia: Lack of muscle coordination affecting movements, speech, and eye movements.
- Balance Problems: Difficulty maintaining balance and walking, often leading to frequent
falls. - Dysarthria: Slurred or slow speech due to muscle control issues. Dystonia: Involuntary muscle contractions causing twisting and repetitive movements.
pROGRESSION:
MSA-C progresses at a variable rate, but it generally leads to significant disability, especially in terms of coordination and balance. The decline in motor skills can be gradual or rapid, impacting daily activities and independence. Autonomic dysfunction in MSA-C may also cause issues like orthostatic hypotension, bladder problems, and gastrointestinal dysfunction.
Diagnosis:
Similar to MSA-P, diagnosing MSA-C requires a thorough evaluation by a neurologist. Diagnostic tools include clinical assessments, neuroimaging studies, and tests to evaluate cerebellar function and autonomic systems. Distinguishing MSA-C from other conditions, such as multiple sclerosis or cerebellar ataxias, is crucial for accurate diagnosis.
MSA-C presents with symptoms that affect the part of the brain known as the cerebellum, which coordinates and regulates muscular activity. Due to the cerebellum’s role in synchronizing motor movements, people with MSA-C often have difficulty with coordination when it comes to walking, hand movements, speech, and eye movements.
Common symptoms include:
- Dropping things
- Finding it difficult to fasten buttons
- Feeling unsteady or clumsy in crowds
- Unable to balance without support
- Difficulty writing
- Slurred speech
Symptoms:
MSA-C, or Cerebellar MSA, primarily affects the cerebellum, the part of the brain responsible for
coordination and balance. The main symptoms include:
- Ataxia: Lack of muscle coordination affecting movements, speech, and eye movements.
- Balance Problems: Difficulty maintaining balance and walking, often leading to frequent falls.
- Dysarthria: Slurred or slow speech due to muscle control issues.
- Dystonia: Involuntary muscle contractions causing twisting and repetitive movements.
Progression:
MSA-C progresses at a variable rate, but it generally leads to significant disability, especially in terms of coordination and balance. The decline in motor skills can be gradual or rapid, impacting daily activities and independence. Autonomic dysfunction in MSA-C may also cause issues like orthostatic hypotension, bladder problems, and gastrointestinal dysfunction.
Diagnosis:
Similar to MSA-P, diagnosing MSA-C requires a thorough evaluation by a neurologist.
Diagnostic tools include clinical assessments, neuroimaging studies, and tests to evaluate
cerebellar function and autonomic systems. Distinguishing MSA-C from other conditions, such as multiple sclerosis or cerebellar ataxias, is crucial for accurate diagnosis.
MSA-P is the more common type of multiple system atrophy. The most common symptoms seen with MSA-P are those that are similar to Parkinson’s disease. These symptoms may include slowness or difficulty initiating movement, increased falls due to walking problems associated with shuffling of gait, tremor, rigidity or muscle stiffness, slurred speech, voice changes, drooling, difficulty swallowing, and lack of facial expression.
In the early stages, MSA-P may respond to medications used for Parkinson’s disease; however, MSA-P progresses more rapidly than Parkinson’s and eventually, most patients no longer respond to those medications.
Other common symptoms may include:
- Problems with balance and posture
- Writing becoming small and spidery
- Sleep disturbances
- Difficulty turning in bed
Symptoms:
MSA-P, also known as Parkinsonian MSA, shares many symptoms with Parkinson’s disease.
The key symptoms include:
- Tremors: While less common than in Parkinson’s disease, tremors can occur, typically in the hands and fingers.
- Bradykinesia: Slowness of movement, making simple tasks difficult and time-consuming.
- Rigidity: Muscle stiffness that can affect any part of the body, leading to a limited range of motion.
- Postural Instability: Difficulty maintaining balance, increasing the risk of falls.
Progression:
MSA-P tends to progress rapidly compared to Parkinson’s disease. Patients often experience a
swift decline in motor functions, which can lead to severe disability within a few years of onset.
The disease’s progression varies among individuals, but the loss of autonomic functions is a significant concern, contributing to symptoms like blood pressure irregularities, urinary incontinence, and erectile dysfunction.
Diagnosis:
Diagnosing MSA-P involves a combination of clinical evaluation, medical history, and diagnostic tests. Neurologists may use brain imaging techniques, such as MRI or DAT scans, and autonomic function tests to rule out other conditions and confirm the diagnosis.
In the early stages, MSA-P may respond to medications used for Parkinson’s disease; however, MSA-P progresses more rapidly than Parkinson’s and eventually, most patients no longer respond to those medications.
Other common symptoms may include:
- Problems with balance and posture
- Writing becoming small and spidery
- Sleep disturbances
- Difficulty turning in bed
Key Differences Between MSA-C and MSA-P
Primary Affected Areas
MSA-P primarily impacts the basal ganglia, leading to Parkinsonian symptoms.
MSA-C mainly affects the cerebellum, causing ataxia and coordination issues.
Symptom Onset
MSA-P symptoms often start with motor dysfunction similar to Parkinson’s disease.
MSA-C symptoms typically begin with coordination problems and balance difficulties.
Symptom Onset
MSA-P generally progresses more rapidly than MSA-C, with a quicker decline in
motor function.
MSA-C progression can be slower, focusing more on coordination and balance
challenges.
Living with MSA
Understanding the differences between MSA-P and MSA-C is vital for patients, caregivers, and healthcare providers. Early diagnosis and tailored management plans can significantly improve the quality of life for those affected. It’s essential to stay informed, seek support, and connect with healthcare professionals specializing in neurodegenerative diseases.
SUPPORT AND RESOURCES
If you or a loved one is dealing with MSA, numerous resources and support groups are available. Connecting with others who understand the challenges of MSA can provide comfort, information, and assistance in navigating the complexities of this condition.
For more information and support, visit Mission MSA or contact us at info@missionmsa.org.
