UNDERSTANDING MSA

Symptoms of Multiple System Atrophy

Understanding symptoms of MSA

Multiple System Atrophy (MSA) is a rare, progressive neurological condition. It can affect movement and coordination as well as automatic body functions such as blood pressure, bladder control and digestion. The type, combination and severity of symptoms vary considerably between people.

Many of the symptoms below can also have other causes. Having one or more of these symptoms does not mean a person has MSA. A GP or neurologist can assess symptoms, consider other explanations and discuss appropriate investigations.

Movement, balance and coordination

Changes in the way a person moves may include:

Slower movements or difficulty starting or completing everyday movements.
Muscle stiffness, changes in posture or sometimes tremor.
Unsteadiness, reduced balance or a greater risk of falls.
Clumsiness or difficulty coordinating hands, arms and legs.
Changes in speech, such as a softer voice or words becoming less clear.

Blood pressure, bladder and other automatic functions

The autonomic nervous system controls many functions that happen without conscious effort. Symptoms may include:

Light-headedness, dizziness or fainting on standing because blood pressure falls (orthostatic hypotension).
Urinary urgency, frequency, leakage or difficulty emptying the bladder.
Constipation or other changes in bowel function.
Changes in sweating or difficulty regulating body temperature.
Sexual-function changes, which can be difficult to discuss but are worth raising with a healthcare professional.

Speech, swallowing, breathing and sleep

Some people experience:

Slurred or quiet speech and difficulty communicating clearly.
Problems chewing or swallowing, including coughing or choking when eating or drinking.
Noisy or high-pitched breathing, especially during sleep; loud snoring or sleep-related breathing problems.
Disturbed sleep, including acting out dreams (REM sleep behaviour disorder).

Breathing and swallowing concerns should be discussed promptly with the person’s treating team. They may require assessment by a speech pathologist, sleep specialist or other clinician.

MSA-P and MSA-C

MSA is often described according to which movement symptoms are more prominent. MSA-P is more associated with slowed movement and muscle stiffness. MSA-C is more associated with balance and coordination difficulties. Autonomic symptoms can occur in both, and the patterns can overlap or change over time.

Read more about Types of MSA or the diagnostic process.

Recognising changes and preparing for an appointment

Keeping notes can help a healthcare professional understand what is happening. Consider recording when symptoms began, whether they are changing, any falls or fainting episodes, bladder or bowel concerns, sleep and swallowing changes, and medicines currently taken. Bring the notes to a GP or neurologist appointment if useful.

For practical next steps, visit Newly Diagnosed With MSA, Managing MSA, or Patient & Family Support.

When to seek medical assistance

New or worsening fainting, repeated falls, swallowing difficulties or changes in nighttime breathing should be raised promptly with a qualified healthcare professional. In an emergency, such as severe difficulty breathing or choking, call 000 in Australia.

This page provides general educational information only and cannot diagnose MSA or replace individual medical advice. Management decisions should be made with the person’s treating healthcare team.

Sources and clinical review

The following independent medical and patient information sources informed this plain-language overview:

Prepared for National MSA Research website staging review on 2 November 2026. A qualified Medical or Research Advisor must review clinical accuracy, wording and source currency before public launch.