Short answer · Medically reviewed summary · Last updated: 2026-05-08
Multiple Systems Atrophy is primarily a clinical diagnosis, as there is no single definitive blood test or biomarker to identify it. Physicians diagnose Multiple Systems Atrophy by evaluating the progression of autonomic failure—such as orthostatic hypotension or urinary retention—alongside motor symptoms like slow movement or rigidity, often relying on the 2008 Gilman criteria or updated 2022 consensus criteria to distinguish it from other neurodegenerative disorders. How is Multiple Systems Atrophy diagnosed? The diagnostic process for Multiple Systems Atrophy is often a "diagnostic odyssey" because symptoms frequently overlap with Parkinson’s disease.
5 people with Multiple Systems Atrophy have shared their first-person experience on this question at DiseaseMaps.
How is Multiple Systems Atrophy diagnosed?
How Multiple Systems Atrophy is diagnosed: tests, specialists and the diagnostic journey, told by patients and reviewed against medical sources.
Multiple Systems Atrophy is primarily a clinical diagnosis, as there is no single definitive blood test or biomarker to identify it. Physicians diagnose Multiple Systems Atrophy by evaluating the progression of autonomic failure—such as orthostatic hypotension or urinary retention—alongside motor symptoms like slow movement or rigidity, often relying on the 2008 Gilman criteria or updated 2022 consensus criteria to distinguish it from other neurodegenerative disorders.
How is Multiple Systems Atrophy diagnosed?
The diagnostic process for Multiple Systems Atrophy is often a "diagnostic odyssey" because symptoms frequently overlap with Parkinson’s disease. Patients often face significant frustration, as it can take months or years to differentiate the condition from other parkinsonian syndromes. A neurologist typically leads the evaluation, focusing on the history of autonomic dysfunction and movement disorders.
What tests are used to evaluate Multiple Systems Atrophy?
While imaging and physical tests cannot confirm the disease alone, they are essential for ruling out other conditions. Key diagnostic tools include:
- Autonomic testing: Tilt-table testing to measure blood pressure drops (orthostatic hypotension) and bladder scans to check for urinary retention.
- MRI of the brain: Specialized imaging may show the "hot cross bun" sign in the pons or atrophy in the cerebellum, which are hallmark indicators of Multiple Systems Atrophy.
- Polysomnography: Used to evaluate central sleep apnea and stridor, which are frequently reported by our 911 community members.
- DaTscan: A specialized imaging test to help distinguish Multiple Systems Atrophy from essential tremor or other movement disorders.
Why is a specialist necessary for Multiple Systems Atrophy?
Because Multiple Systems Atrophy is rare and complex, general practitioners may not recognize the subtle combination of autonomic and motor symptoms. Seeking a movement disorder specialist or an autonomic neurologist is critical. These specialists are trained to identify the specific diagnostic criteria that differentiate this condition from Parkinson’s, Lewy Body Dementia, or Pure Autonomic Failure, ensuring you receive the most accurate information regarding your care.
Next steps
- Consult a movement disorder specialist or an autonomic neurologist for a comprehensive evaluation.
- Keep a detailed log of blood pressure readings and urinary symptoms to share during your clinical visits.
- Join the Multiple Systems Atrophy community at DiseaseMaps.org to connect with others who have navigated the diagnostic process.
- Ask your physician about participating in clinical trials for emerging therapies.
Medical disclaimer: This information is for educational purposes only and does not replace professional medical advice, diagnosis, or treatment.
References
- NIH Genetic and Rare Diseases Information Center (GARD): Multiple System Atrophy
- Orphanet: Multiple System Atrophy (ORPHA:604)
- Movement Disorder Society: Consensus Criteria for the Diagnosis of Multiple System Atrophy
- The MSA Coalition: Understanding the Diagnostic Process
Posted Jul 9, 2017 by Mary 1000
Posted Jul 11, 2017 by Pam Bower 2952
Posted Jan 4, 2018 by Jan 1500
A significan percentage are diagnosed with Parkinson’s Disease until it becomes obvious that Dopamine is not effective or that the progression of the disease is not following the expected course. There are a number of other “Parkinson’s Plus” diseases as well as Autonomic Failure, MS, ALS, normal presdure Hydrocephalus that will be ruled out prior to making the diagnosis.
Posted Mar 23, 2018 by [email protected] 3020
Posted May 10, 2017 by Lorena 1000
