Language
Country/Area
No result found
From Parkinson's to MSA: Why is Multiple System Atrophy Misdiagnosed?
Multiple system atrophy (MSA) is a rare neurodegenerative disease whose symptoms often mimic those of Parkinson's disease, which complicates diagnosis. The characteristics of MSA include tremor, bradykinesia, muscle stiffness, and postural instability, accompanied by dysfunction of the autonomic nervous system, which causes patients to face various discomforts such as orthostatic hypotension, sexual intercourse dysfunction, and decreased sweating. In addition, vocal cord paralysis is sometimes one of the first clinical manifestations of the disease. The overlap of these characteristics causes many patients to be misdiagnosed as Parkinson's disease at the initial stage.
Most patients with multiple system atrophy develop symptoms between the ages of 50 and 60, and 55% of cases are male, making early diagnosis quite challenging.
Symptoms of MSA vary from person to person and may include difficulty with movement coordination and an unsteady gait. During the progression of symptoms, about 62% of patients first show "akinesis-rigid syndrome", that is, slow initiation of movement. During this stage, patients often develop balance problems, and at initial diagnosis, 22% of cases exhibit cerebellar dyskinesia.
In addition, problems with the autonomic nervous system are particularly pronounced in MSA, and patients may suffer from urinary urgency, dysuria, and other neurological symptoms, which are often overlooked in the early stages, further delaying diagnosis. Because the various symptoms of MSA are sometimes similar to other diseases, coupled with the shortage of specialist doctors, many patients do not receive the correct diagnosis and treatment in time.
Many patients with MSA do not respond well to dopamine agonists for Parkinson's disease, which can be an important indicator of differential diagnosis.
Although research suggests that MSA can lead to further neuronal degeneration, at least in some patients, the exact cause remains unclear. The latest research mentions that alpha-synapsin may play an important role in this pathology, but as time goes by, scientists are still working to understand the complexities of this disease.
The challenge in differential diagnosis of MSA is that its clinical manifestations are diverse and may be confused with a variety of other neurodegenerative diseases. Unless pathological examination is performed at autopsy, it is difficult to determine whether a patient actually has MSA. Because the pathological characteristics of MSA are often not detected in early examinations, most cases are diagnosed after the onset of obvious symptoms.
Over time, people with MSA often experience a gradual decline in their ability to exercise, which greatly affects their quality of life. Managing patients with this disease requires the support of a multidisciplinary team, including neurologists, physical therapists, and occupational therapists, among others. They can provide appropriate rehabilitation programs to help patients adjust better to life.
Patients with MSA typically live 6 to 10 years after diagnosis, and approximately 60% of patients require a wheelchair within five years.
Although there is currently no cure for MSA, managing the various symptoms can significantly improve quality of life. This requires close collaboration between social support, medical resources, and the patient's family.
Faced with this complex disease, we need to think about: What factors in diagnosis and treatment may cause the medical community to misdiagnose multiple system atrophy as other diseases?
