Multiple system atrophy (MSA) is a degenerative process affecting the brain and other organ systems. There are several subtypes that can cause various combinations of findings, including unsteadiness, clumsiness, trouble pronouncing words, and fainting. MSA can be difficult to distinguish from several other diseases, but this distinction may be clarified through various tests such as a brain imaging, ocular motor studies, tests of cardiac function, and others, though sometimes even after doing such tests, the diagnosis remains unclear. There is no arrestive or curative treatment. From the time of symptom onset, most patients die within about 10 years.