Objective:

This study aims to explore the diagnostic and therapeutic challenges faced in the management of Multiple System Atrophy (MSA) in low-resource settings, focusing on the healthcare system of Nepal. It seeks to identify gaps in early diagnosis, access to advanced diagnostic tools, and the availability of treatment options for MSA patients.

Background: MSA is a rare and progressive neurodegenerative disorder. Despite advances in neuroimaging and clinical management, early diagnosis and effective treatment of MSA remain elusive, particularly in resource-limited countries like Nepal. The scarcity of specialized healthcare services, limited access to advanced diagnostic modalities such as MRI and genetic testing, and the lack of comprehensive multidisciplinary care teams pose significant barriers to optimal patient management.

Method: This retrospective study reviewed the medical records of patients diagnosed with MSA at a tertiary care hospital in Nepal. Data on demographic characteristics, clinical presentations, diagnostic approaches, therapeutic interventions, and patient outcomes were collected. Additionally, interviews with healthcare providers were conducted to gain insights into the challenges they face in diagnosing and managing MSA.

Results: Out of 25 patients identified with clinical features suggestive of MSA, only 10 received a definitive diagnosis, with most cases relying on clinical criteria due to the unavailability of advanced imaging and genetic testing. A significant delay in diagnosis was noted, with patients presenting for care after several months or even years of symptom onset. Common diagnostic challenges included the overlap of MSA symptoms with other neurodegenerative diseases and the lack of specialized expertise in movement disorders. Therapeutic options were largely symptomatic, with limited access to disease-modifying treatments. The absence of multidisciplinary care, including physiotherapy and speech therapy, further hindered patient outcomes.

Conclusion: The lack of effective disease-modifying therapies and multidisciplinary care systems makes it difficult to provide optimal care for MSA patients. Strengthening healthcare infrastructure, training healthcare professionals in movement disorders, and improving access to diagnostic tools are essential to enhancing the management of MSA in resource-constrained environments.

Patient Demographics

Diagnostic Challenges in MSA

Therapeutic Management

« Back to 2025 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/challenges-in-diagnosing-and-managing-multiple-system-atrophy-in-low-resource-settings-insights-from-nepal/