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Multiple system atrophy -LRB- MSA -RRB- , also known as Shy-Drager syndrome , is a rare neurodegenerative disorder is characterized by tremors , slow movement , muscle rigidity , and postural instability balance difficulties -LRB- collectively known as parkinsonism -RRB- due to the dysfunction of the autonomic nervous system , and ataxia .. neurodegenerative disorder. neurodegenerative disorder. slow movement. bradykinesia. postural instability. postural instability. parkinsonism. parkinsonism. autonomic nervous system. autonomic nervous system. ataxia. ataxia. This is caused by progressive degeneration of neurons in several parts of the brain including the substantia nigra , striatum , inferior olivary nucleus , and cerebellum .. brain. brain. substantia nigra. substantia nigra. striatum. striatum. inferior olivary nucleus. inferior olivary nucleus. cerebellum. cerebellum. Many people affected by multiple system atrophy experience dysfunction of the autonomic service system which commonly manifests as orthostatic hypotension , impotence , loss of sweating , dry mouth and urinary retention and incontinence .. orthostatic hypotension. orthostatic hypotension. impotence. impotence. loss of sweating. anhidrosis. dry mouth. Xerostomia. urinary retention. urinary retention. incontinence. urinary incontinence. Vocal cord palsy is an important and sometimes initial clinical manifestation of the disorder .. The cause of MSA is unknown and no specific risk factors have been identified , although research indicates that a prion form of the alpha-synuclein protein may be the cause of the disease .. prion. prion. alpha-synuclein. alpha-synuclein. Approximately 55 % of MSA cases occur in men , with typical age of onset in the late 50s to early 60s .. MSA often presents with some of the same symptoms as Parkinson 's disease .. However , those with MSA generally show little response to the dopamine medications used to treat Parkinson 's disease .. dopamine medications. Dopamine agonist. MSA is distinct from the more common syndrome multisystem proteinopathy .. multisystem proteinopathy. multisystem proteinopathy. It should also not be confused with the two terms multiple organ dysfunction syndrome , which is the more modern and accurate term for multiple organ failure or multiple organ system failure , which is an often-fatal complication of septic shock or other very severe illnesses or injuries .. multiple organ dysfunction syndrome. multiple organ dysfunction syndrome. organ failure. organ failure. septic shock. septic shock