Expectations (Prognosis) What is the progression of MSA?
Disease progression in MSA is quicker than in Parkinsonism but similar or slightly slower to that of Progressive Supranuclear Palsy (PSP) (Bower, 1997). Almost 80% of patients are disabled within 5 years of onset of the motor symptoms, and only 20% survive past 12 years. The mean survival is roughly 6 years. Rate of progression differs in every case and speed of decline may vary widely in individual patients. Patients usually have autonomic nervous system dysfunction first. Genitourinary dysfunction (difficulty with urination) is the most frequent initial complain in women, while impotence is the most frequent initial complaint in men. When MSA begins with non-autonomic features, imbalance is the most common feature. This difficulty in maintaining balance may be due to either cerebellar or Parkinsonian abnormalities. Some patients complain of stiffness, clumsiness, or a change in handwriting at the onset of MSA. MSA progresses over the course of several years to cause more widespread a
