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Multiple System Atrophy is a Parkinson mimic. Some people call this atypical Parkinson or Parkinson Plus Disease. So patients often present a little bit younger than Parkinson's - between 40 to 60 and they present a bit like Parkinson's.
Their walking might be slow or they have tremor but where they really differ is that they seem to have a more aggressive course and they have problems early with their balance, slurring their words and actually develop problems of the nervous system that we don't think about, such as controlling blood pressure where they start fainting early in the course of their disease or control and of their bladder such that they may not be able to empty their bladder or hold on to their urine and they become incontinent. As I say, unfortunately it seems to be that this is a more aggressive disease than Parkinson's and often doesn't respond to the treatments that we have and most of our approaches are therefore supportive.