Symptoms of MSA vary in distribution, onset and severity from person to person. Shy-Drager syndrome, striatonigral degeneration, and olivopontocerebellar atrophy. In Shy-Drager syndrome, the most prominent symptoms are those involving the autonomic system, the body system that regulates blood pressure, urinary function, and other functions not involving conscious control. Striatonigral degeneration causes parkinsonian symptoms such as slowed movements and rigidity , while olivopontocerebellar atrophy principally affects balance, coordination, and speech. MSA progresses over the course of several years to cause more widespread and severe symptoms.
Orthostatic hypotension can cause fainting and falls.
Loss of coordination, slowed movements, and rigidity can interfere with activities of daily living . Some patients with MSA have mild loss of cognitive abilities, with impairments in attention and speed of thinking. A number of drugs can be used to treat the various symptoms of MSA, although they become less effective as the disease progresses. Orthostatic hypotension can be improved with fludrocortisone, midodrine, or other drugs that raise blood pressure. Male impotence may be treated with penile implants or drugs.