Multiple system atrophy (MSA) affects many parts of your body. Symptoms usually start in adulthood, usually in the 50s or 60s. There are two types of MSA: parkinsonian and cerebellar. The type depends on the symptoms you have when you're diagnosed. MSA Parkinsonian type This is the most common type of MSA. The signs and symptoms are similar to those of Parkinson's disease, such as: MSA 
Stiff muscles
Difficulty bending your arms and legs
Slow movement (bradykinesia)
Tremors can occur at rest or when moving your arms or legs
Soft voice
Problems with posture and balance
 Cerebellar type The main signs and symptoms are problems with muscle coordination (ataxia), but others may include: 
Impaired movement and coordination, such as unsteady gait and loss of balance
Slurred, slow or low-volume speech (dysarthria)
Visual disturbances, such as blurred or double vision and difficulty focusing your eyes
Difficulty swallowing (dysphagia) or chewing
Changes in speech, such as slurred speech 
 General signs and symptoms In addition, the primary sign of multiple system atrophy is autonomic failure, which may cause problems with body functions you can't control. This may include: Postural (orthostatic) hypotension Postural hypotension is a form of low blood pressure that makes you feel dizzy or lightheaded, or even faint, when you stand up from sitting or lying down. Not everyone with MSA has postural hypotension. MSA You can also develop dangerously high blood pressure levels while lying down (supine hypertension). Urinary and bowel dysfunction 
Constipation
Loss of bladder or bowel control (incontinence)
 Changes in sweat production 
Producing less sweat
Heat intolerance due to reduced sweating
Impaired body temperature control, often causing cold hands or feet
 Sleep disorders 
Agitated sleep due to "acting out" dreams
Abnormal breathing at night or a harsh breathing sound (stridor)
 Sexual dysfunction 
Inability to achieve or maintain an erection (impotence)
Loss of libido
 Cardiovascular problems 
Color changes in hands and feet caused by pooling of blood
 Psychiatric problems 
Difficulty controlling emotions, such as laughing or crying inappropriately
