Unfortunately yes: As MSA progresses, every muscle in the body eventually gets affected by the degeneration of the autonomic nerves & other derangements which cannot be compensated for anymore by the "voluntary" nervous system. I have a patient who is likely going through his last stages & it is a relentless disease process for which he now refuses any & all interventions to help him with breathing or swallowing.
Answered 10/26/2018
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