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Shy-Drager syndrome, also called "multiple system atrophy with orthostatic hypotension" or "MSA" is a rare, serious and unknown cause, characterized by the degeneration of cells in the central and autonomic nervous system, which controls the functions involuntary changes in the body.
The symptom that is present in all cases, is the drop in blood pressure when the person gets up or lies down, however others may be involved and for this reason it is divided into 3 types, the differences of which are:
- Parkinsonian shy-drager syndrome: presents the symptoms of Parkinson's disease, such as, where slow movements, muscle stiffness and tremors;
- Cerebellar shy-drager syndrome: impaired motor coordination, difficulty in balancing and walking, focusing on vision, swallowing and speaking;
- Combined shy-drager syndrome: covers the parkinsonian and cerebellar forms, being the most severe of all.
Although the causes are unknown, there is a suspicion that shy-drager syndrome is inherited.
Main symptoms
The main symptoms of Shy-Drager syndrome are:
- Decrease in the amount of sweat, tears and saliva;
- Difficulty seeing;
- Difficulty urinating;
- Constipation;
- Sexual impotence;
- Heat intolerance;
- Restless sleep.
This syndrome is more common in men after the age of 50. And because it does not have specific symptoms, it can take years to reach the right diagnosis, thus delaying proper treatment, which, despite not curing, helps to improve the person's quality of life.
How the diagnosis is made
The syndrome is usually confirmed by an MRI scan to see what changes the brain can undergo. However, other tests can be done to assess involuntary functions of the body, such as measuring blood pressure lying and standing, sweat test to assess sweating, bladder and bowel, in addition to the electrocardiogram to track electrical signals from the heart.
How the treatment is done
The treatment of Shy-Drager syndrome consists of relieving the symptoms presented, as this syndrome has no cure. It usually includes the use of medications such as seleginin, to decrease the production of dopamine and fludrocortisone to increase blood pressure, as well as psychotherapy so that the person can better deal with the diagnosis and physiotherapy sessions, to avoid muscle loss.
In addition to help relieve symptoms, the following precautions may be indicated:
- Suspension of the use of diuretics;
- Raise the head of the bed;
- Sitting position to sleep;
- Increased salt consumption;
- Use elastic bands on the lower limbs and abdomen, reducing the discomfort caused by tremors.
It is important to note that the treatment for Shy-Drager Syndrome is so that the person can have greater comfort, as it does not prevent the progression of the disease.
Because it is a difficult to treat disease and progressive in nature, it is common for death to be caused by cardiac or respiratory problems, from 7 to 10 years after the onset of symptoms.