Multiple system atrophy (MSA) is a rare, progressive neurodegenerative disorder that affects multiple systems of the body, particularly movement, balance, and autonomic functions. MSA progresses faster than Parkinson’s disease and significantly shortens life expectancy, with most patients surviving 6–10 years after symptom onset.

• Cause: The exact cause is unknown, but it's linked to abnormal buildup of the protein alpha-synuclein in brain cells. It is not inherited and typically develops sporadically in adulthood, usually after age 50.

• Features: Parkinsonian symptoms - slowness, stiffness, tremor (MSA-P); cerebellar symptoms - poor coordination, speech and gait problems (MSA-C); autonomic dysfunction - severe low blood pressure, urinary incontinence, erectile dysfunction, and impaired sweating

• Diagnosis: Based on clinical symptoms, neurological exams, MRI findings, and ruling out similar conditions like Parkinson’s disease. No definitive test exists while the patient is alive.

• Treatment: No cure. Treatment focuses on relieving symptoms with medications (e.g., for motor symptoms or blood pressure), physical therapy, and support for autonomic issues.