Wisdom of Life


Multiple system atrophy (MSA) is a progressive neurological disorder that affects adult men and women. It is caused by degeneration or atrophy of nerve cells in several (or multiple) areas of the brain which can result in problems with movement, balance and automatic functions of the body such as bladder and blood pressure control.

The Oluwafunmilayo Khafasat Fashina Foundation is a Nigerian based support and information service for people with multiple system atrophy, their families and carers. It also funds research into the treatment and causes of MSA.

The cause of MSA is unknown and no specific risk factors have been identified. Around 55% of cases occur in men, with typical age of onset in the late 50s to early 60s.

The overall prevalence of MSA is estimated at 4.6 cases per 100,000 people.This disease is more common in men than in women, with studies showing ratios ranging from between 1.4:1 to ratios as high as 1.9:1.

MSA is characterized by a combination of the following, which can be present in any combination:

  • Autonomic dysfunction
  • Parkinsonism (muscle rigidity +/ tremor and slow movement)
  • Ataxia (Poor coordination / unsteady walking)

MSA usually progresses more quickly than Parkinson’s disease.There is no remission from the disease. The average remaining lifespan after the onset of symptoms in patients with MSA is 7.9 years.

Almost 80% of patients are disabled within 5 years of onset of the motor symptoms, and only 20% survive past 12 years.Rate of progression differs in every case and speed of decline may vary widely in individual patients.

’Sullivan and colleagues (2008) identified early autonomic dysfunction to be the most important early clinical prognostic feature regarding survival in MSA.

Patients with concomitant motor and autonomic dysfunction within 3 years of symptom onset had a shorter survival duration, in addition to becoming wheelchair dependent and bed-ridden at an earlier stage than those who developed these symptoms after 3 years from symptom onset.

Their study also showed that when patients with early autonomic dysfunction develop frequent falling, or wheelchair dependence, or severe dysphagia, or require residential care, there is a shorter interval from this point to death.