autonomic dysfunction?

[PaulaG3]

in the early stages is autonomic dysfunction usual and part of diagnosis?

I’ve read a key feature is OHwhich I do not have.

[Yanno]

Hello Paula, as always we're sorry that you need to be here but you are nevertheless very welcome.

If you read some of the past posts, you will quickly appreciate that everyone's journey is different which is why MSA is so difficult to diagnose. The MSA Trust has a range of fact sheets that you may find helpful including one on Diagnosis of MSA which you can find here: msatrust.org.uk/wp-content/...

There's also a very useful Guide to MSA which is available in printed form from the Trust or you may download it here: msatrust.org.uk/wp-content/...

I wish you luck in your search for some answers.

Take care, Ian

[PaulaG3 in reply to Yanno]

thank you Ian x

[ReverendBadger]

Hi Paula,

There are many autonomic systems in the body and MSA can cause dysfunction in lots of them. As Ian says everyones symptoms can vary, there is no set progression of symptom milestones. However it is quite common for some autonomic dysfunction to appear early (often before MSA diagnosis) and this frequently includes balance problems (falling over unexpectedly,falling backwards),urinary problems(frequency,urgency,etc) and bowel problems(irregularity). Some people with MSA may have blood pressure dysfunction early but don't forget that OH is both a qualitative and a quantative issue and visible symptoms may only appear sometimes e.g. standing up quickly.

Many autonomic dysfunctions can have more obvious causes than rare neurological conditions like MSA so even if you have 2 or 3 it won't necesarily get a GP or consultant thinking "is this neurological?" unless other stuff is going on.

OH is not common like bladder problems for example and obvious simple causes like temporary dehydration are easily diagnosed and dealt with. Once that is eliminated then autonomic failure from neurological origin comes to the fore. Hence it can be useful in MSA diagnosis particulary once analysed quantitatively such as from a 24hr recording of BP.

Not having OH is not an indication of you not having MSA. I have multiple autonomic failures but only ,normally, very mild OH but maybe once a month it can go really stupid. Next week/month/year I might have it very differently. There is virtually no doubt I have MSA though and interestingly my CAT and MRI brain scans are perfectly clear.

MSA is a tricky thing but I am pretty confident that the accuracy of diagnosis is better now than it was even 10 years ago.

[PaulaG3 in reply to ReverendBadger]

thank you so much reverend badger. I’m so sorry to hear about your issues. I am learning that it’s must be so difficult to diagnose. Thanks again x