Multiple systems atrophy
What is theMultiple systems atrophy?
AMultiple Systems Atrophy (AMS) is a rare disease that leads to symptoms of stiffness, slowness of movement, falls, and especially dysautonomia.
The disease can be similar to Parkinson's disease and even be indistinguishable, that is, not being able to be differentiated from one another.
There are two forms of AMS. AMS-P, which has similarities to Parkinson's disease, and AMS-C, where cerebellar symptoms are present, and the person has imbalances, characteristic of the ataxia present.
AMS-P corresponds to 80% of cases of AMS. And AMS-C in 20% of cases.
The disease is part of the movement disorder group of diseases, coursing with a form ofparkinsonism.
parkinsonismis the set of symptoms characterized by:
Bradykinesia (slowness of movement), associated with muscle rigidity and/or tremor.
When we talk about Parkinson's disease, we are talking about a disease, which also has parkinsonism.
In AMS, in addition to parkinsonism, other characteristics that help to differentiate from Parkinson's disease are the presence of dysautonomia.
What is dysautonomia?
Dysautonomia is the name given to the dysregulation of a part of the nervous system, called the autonomic nervous system. This system controls some so-called automatic functions. Such as urine, erectile function, heart rate, blood pressure, among others.
Thus, a person with dysautonomia may have urgency to urinate, sexual impotence, sudden changes in pressure (suddenly the pressure rises a lot, after the person stands up, the pressure drops quickly, causing the patient to become dizzy and even faint), among others. other symptoms.
AMS It is rare and therefore very difficult to diagnose. It is almost always diagnosed as "difficult to treat" Parkinson's disease.
How is Multiple System Atrophy diagnosed?
AMS is diagnosed mainly through thepresence of symptomsdescribed above, or part of them, associated with characteristic changes in the cranial (or brain) MRI.
In the skull resonance, one can find regional atrophy of the putamen, and a very characteristic sign, called Maltese cross (or HOT CROSS BUN SIGN).
How is Multiple Systems Atrophy treated?
Treatment of Multiple System Atrophy is directed at specific symptoms.
First is the treatment of parkinsonism.
Treatment of parkinsonism can be carried out using medications similar to those used for the treatment of Parkinson's disease.
Like levodopa, pramipexole, rasagiline. The dose, times of taking can vary greatly.
Non-drug treatment is very important and should be done with physiotherapy, pilates, speech therapy and aerobic physical activity, which can be performed through water aerobics, running, among others.
Dysautonomia treatment
The treatment ofdysautonomiait can be complex. But it is almost always guided by the symptom. Thus, once there is erectile dysfunction, drugs such as tadalafil, sildenafil, among others, can be used.
If you experience dizziness, it is often due to postural hypotension (pressure drops when standing up). And so can be used drugs to increase pressure, such as Florinefe®, and many others.
The treatment of other possible symptoms, such as sleep disturbance, sleep apnea and others, must be individualized.