Shy Drager Syndrome: An Overview

Shy Drager Syndrome or Multiple System Atrophy (MSA)

Shy Drager syndrome is the old term used to refer to a movement disorder that causes affects several organs. In this regard, the proper name of the disease is multiple system atrophy (MSA) with orthostatic hypotension. It usually develops in men between the ages of 35 and 75.

Multiple system atrophy (MSA) is rare and can be misdiagnosed as Parkinson’s disease. The signs and symptoms of this disease result from atrophy of parts of the nervous system that involve autonomic functions. It affects different parts of the central and peripheral nervous system leading to motor, sensory, and organ dysfunction. The circulatory, urinary, gastrointestinal, and muscular systems can be affected.

Signs and Symptoms of MSA

The signs and symptoms of MSA depend on the affected organs.

The condition can be divided into three main presentations:

1. Cerebellar- the cerebellum is mainly affected in this presentation of the illness, so the person is likely to have difficulties with walking and talking.

2. Parkinsonian- this type resembles Parkinson’s disease and is characterized by a slow-rolling gait.

3. Combined- the combined presentation of this disease has symptoms and signs of cerebellar involvement and resembles Parkinson’s disease.

Overall MSA has an orthostatic component to it when it involves the circulatory system. Someone with this disease will have problems controlling their blood pressure. Doctors will notice a sharp decrease in blood pressure when the person rises from a sitting position, and a sharp increase in blood pressure when the person lies down. This results in dizziness, fainting and blurred vision.

If the urinary system is affected, urinary urgency and involuntary leakage of urine occur. Gastrointestinal involvement is similar to urinary system involvement, resulting in fecal incontinence due to poor bowel control.

As this condition worsens, there is an increase in memory loss and confusion. Death can occur as respiration becomes difficult to manage.

Examination and Treatment of Shy Drager Syndrome

There is no definitive test that can be used to confirm this disease. Instead, other conditions must be ruled out. There is also no specific drug used to treat this syndrome. Any medication prescribed will be used to alleviate signs and symptoms of the disease, especially the swings between hypo- and hypertension on rising and lying down.

References

Print Source: Davidson, Stanley & C. Haslett. 2002. “Davidson’s Principles and Practice of Medicine.” Churchill Livingstone, Edinburgh.

Print Source: Cotran R, Kumar V, and Robbins, SL. 1999. Robbins Pathologic Basis of Disease, 6th Ed. W.B. Saunders Company, Philadelphia.

Web Source: Merck Manual of Health & Aging. “Shy-Drager Syndrome.” 2009. Available: https://www.merck.com/mmhe/sec14/ch173/ch173h.html