Multiple system atrophy is a disorder that is very progressive , fatal which makes the muscles stiff ( rigid) and causes problems with movement , loss of coordination , and malfunction of the inner body ( such as blood pressure and bladder control ) .
Part of the brain that control movement and many body parts in the process sank .
Some symptoms similar to Parkinson 's disease , but the process also damaged the inside of the body .
Doctors base the diagnosis on symptoms .
Tools and simple medicines can help reduce the symptoms , but the disorder is very progressive and ultimately fatal .
Multiple system atrophy usually begins when a person is 50 years old . which affects about twice as many men than women . Resulting from the decline in some parts of the brain and spinal cord .
Basal ganglia ( collection of nerve cells at the base of the cerebrum , on the inside of the brain ) , which helps control voluntary muscle movement by balancing the movement of the bands of muscles that move the same muscle on the opposite way ( eg , a group which deflect the collection of arms and straightening arm ) .
Cerevellum , which mengkoordinasu voluntary movement ( especially complex movements performed simultaneously .
Regions that control the nervous system automation , which regulate body processes are optional , such as how blood pressure changes in response to changes in posture .
Nerve cells that stimulate nerve movement (motor neurons ) in the cerebellum , basal ganglia , and spinal cords .
CAUSE
The cause of deterioration is unknown .
Multiple system atrophy including three disorders previously thought to separate disturbances :
Olivopontocerebellar atrophy , which is characterized by symptoms similar to Parkinson's disease ( called parkinsonnism ) and difficulty maintaining balance .
Striatonigral slump , which is very similar to Parkinson 's disease levodopa except that it often does not relieve the symptoms .
Shy-Drager syndrome , which is characterized by parkinsonism and problems with urination , blood pressure control , and several other processes in the body .
SYMPTOMS
Multiple system atrophy is a disorder that is very advanced . Early symptoms vary , depending on which part and how much of the brain first affected . The disorder causes the three groups of symptoms .
Parkinsonism - symptoms similar to Parkinson's disease - may soon occur . These symptoms result from basal ganglia kemerosostan . Muscles are stiff ( rigid) , and movement is slow , wobbly , and hard to start . When walking , dragging people can and can not swing their arms . People feel gioyah and gets confused , making them more likely to fall . Posture possibility of stopping . The limbs can be snapped up by vibrating , usually when they are held in one position . But people with Multiple system atrophy is unlikely to experience the thrill during breaks than people with Parkinson's disease . Articulation is a difficult word , and sounds can be pitched and trembling .
Loss of coordination may also occur more quickly . Of deterioration that occurs in the cerebellum . People may not be able to control the movements of the arms and legs . Consequently , they have difficulty walking and requires a step width and irregular . People may have trouble focusing on the eyes and follow objects . Tasks that require the movement back and forth quickly , such as the doorknob or installing a light bulb , also becomes difficult .
Malfunction of the inner body , controlled by the automatic nervous system , can also occur earlier . Blood pressure can decrease dramatically when a person stands , causing dizziness , lightheadedness , or fainting - a condition called orthostatic hypotension . Blood pressure can be increased when someone was lying . People may need to urinate frequently or urgently or can be issued optionally urine (urinary incontinence ) . They may have difficulty emptying the bladder (urinary retention ) . Constipation is common . Vision becomes worse . Men may experience difficulty and start a maintaining an erection ( erectile dysfunction ) .
Other symptoms on automatic malfunction may occur earlier or later . Reduced sweat , tears , and saliva produced . As a result , people may be intolerant to heat and experiencing dry eyes and mouth . People may have difficulty swallowing and breathing . Breath possibility of noisy and high -pitched . During sleep , breathing can stop quickly or becomes inadequate (sleep apnea ) . People can lose control of the movement of stomach contents ( fecal incontinence ) .
Most people confined to a wheelchair or otherwise paralyzed weight within 5 years after symptoms begin . The disorder results in death of 9 to 10 years after symptoms begin .
Diagnosis
The diagnosis is based on symptoms can be similar to other disorders , making it difficult to diagnose the disorder .
The only sure way to diagnose multiple system atrophy is to examine brain tissue after death . Even so , some helped with diagnostic tests , for example , if levodopa relieve parkinsonism , are likely the cause of Parkinson's disease . Levodopa has little or no effect on similar symptoms caused by multiple system atrophy . Magnetic resonance imaging ( MRI ) of the brain can help rule out other neurologic disorders . Tests to evaluate the automatic nervous system kemungkingan done . For example , blood pressure may be measured when a person is sitting and after the person stands to check orthotastic hypotension . The presence of hypotension orthotastic support the diagnosis of multiple system atrophy .
TREATMENT
No treatment can cure multiple system atrophy . Even so , the combination of tools and simple medicines can help relieve symptoms .
Parkinsonism : continue to do so many activities each day helps maintain muscle strength and flexibility . Stretching and exercising regularly may also help . Drugs used to treat Parkinson's disease , such as levodopa plus carbidopa or pergolide , taken by mouth , may be tried, but these drugs usually have little effect or effective for only a few years .
Orthostatic hypotension : a tool to stabilize the sudden change in blood pressure . Consuming more salt and water can increase the amount of blood and thus helps increase blood pressure . Standing up slowly may help prevent decreases in blood pressure when a person stands up too much , as it could use an abdominal binder or compression stockings . These clothes help maintain blood pressure by increasing the flow of blood from the legs to the heart and thus prevent too much blood remains ( pooling ) on foot . Raising the head of the bed by about 4 inches ( 10 cm ) can help prevent blood pressure from increasing too much when the person lies down . If the increased blood pressure , antihypertensive medication ( such as propranolol ) may be taken at night . Fludrocortisone may be taken by mouth . Which helps the body retain salt and water and thus can increase blood pressure when a person stands as needed . Other drugs , such as midrodrine or pyridostigmine , taken by mouth , can also help .
Urinary retention: If necessary , people can learn to insert a catheter into the bladder of their own . They put a couple of times a day . It is inserted through the urethra , making the urinary bladder to dry . People remove the catheter after the bladder is empty . This tool helps prevent stretch the bladder and urinary tract infections are formed . Wash hands , clean the area around the urethra , and the catheter using sterile or clean also helps prevent infection . Inserting a catheter becomes more difficult as coordination deteriorates . Doctors can prescribe bethanechol , which improves the properties of the muscles of the bladder and sometimes makes emptying the bladder more easily .
Urinary incontinence : oxybutynin or tolterodine , taken by mouth , digunaka possibility to relax the muscles of the overactive bladder . If incontinence persists , use a catheter inserted into the bladder can help . Some people learn to enter it yourself .
Constipation : High - fiber diet and stool softeners are recommended . If stubborn constipation , enemas may be needed .
Erectile Dysfunction : Usually, treatment consists of drugs such as sildenafil , tadalafil , or vardenafil , taken by mouth .
As the disorder progresses, people may need a breathing tube , a feeding tube ( usually surgically inserted ) , or both . Physical therapists , occupational, and speech can teach people ways to compensate when walking , daily activities , and talking becomes difficult . Social workers can help find a support group and when the symptoms become disabling , home health care or hospice services .
Problems at the end of life : for this disorder is very progressive and ultimately fatal , people should prepare for further instructions as soon as the disorder is diagnosed . These instructions should indicate whether the type of medical care that people want to end his life .
