Ataxia

neurological sign consisting of lack of voluntary coordination of muscle movements

Ataxia is trouble with balance that is not caused by a person's muscles being weak. Instead, ataxia is caused by a neurological problem.[1]

Ataxia is not a diagnosis. It is a neurological sign. It is a sign of damage to the parts of the nervous system that control balance.[1]

There are three different types of ataxia. Each type has many possible causes.

Cerebellar ataxia

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Cerebellar ataxia is ataxia that is caused by a problem with a person's cerebellum. The cerebellum is the part of the brain that controls balance and coordination. It makes the body move smoothly and controls movements like walking.[2]

People with cerebellar ataxia may have trouble with actions like these:[2][3]

  • Controlling how hard their muscles contract, how fast, and in what direction
  • Getting their muscles to work together (asynergy)
  • Walking (gait abnormality)
  • Moving their eyes
  • Swallowing (dysphagia)
  • Saying words (dysarthria)
  • Judging how far away something is (dysmetria)
  • Reacting quickly

Sensory ataxia

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Sensory ataxia is caused by the loss of proprioception (knowing where parts of the body are). It is usually caused by damage to the parts of the spinal cord that carry information about proprioception to the brain. However, it can also be caused by damage to the parts of the brain that receive that information (the cerebellum, the thalamus, and the parietal lobes of the brain).[1]

A person with sensory ataxia may have these symptoms:

  • They may have trouble walking. They may stomp their feet and hit their heels hard against the ground while they walk
  • Trouble walking that gets worse when the person cannot see well
    • For example, if the person stands with their feet together and their eyes closed, their balance problems will get much worse, and they may fall. Doctors call this a "positive Romberg's test.

Vestibular ataxia

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Vestibular ataxia is caused by problems with the vestibular system. This is the body's main sensory system that controls balance and movement. It includes the inner ear.[4]

Along with balance problems, people with vestibular ataxia may have:

Causes

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There are many different causes of ataxia. The National Ataxia Foundation breaks up these causes into three categories: acquired, genetic, and idiopathic.[4]

Acquired ataxia

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A person is not born with acquired ataxia. Acquired means that something happened during the person's life to cause the ataxia.[4]

Causes of acquired ataxia can include:[4]

Genetic (hereditary) ataxia

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Genetic ataxia is caused by hereditary disorders that damage the cerebellum or spine.[12] People are born with these disorders. In most cases, they get worse over time.[4]

Idiopathic ataxia

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Idiopathic means that doctors cannot find a cause for a person's ataxia.

Idiopathic ataxias often cause symptoms that come and go. Many doctors and scientists think these ataxias are caused by a combination of things inside the body (like gene problems) and things outside the body (like the things happening in a person's life). However, they are still researching the causes of idiopathic ataxias.[4]

Treatment

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Ataxia can be treated. However, treatment usually does not make ataxia go away completely.

Some treatments for ataxia include:[13] A review of the management of degenerative ataxia was published in 2009.[14]

Some people with severe ataxia may need to use wheelchairs.

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References

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  1. 1.0 1.1 1.2 "Frequently Asked Questions About... Ataxia" (PDF). National Ataxia Foundation. Archived from the original (PDF) on April 8, 2016. Retrieved September 18, 2016.
  2. 2.0 2.1 Schmahmann JD (2004). "Disorders of the cerebellum: ataxia, dysmetria of thought, and the cerebellar cognitive affective syndrome". J Neuropsychiatry Clin Neurosci. 16 (3): 367–78. doi:10.1176/appi.neuropsych.16.3.367. PMID 15377747.
  3. Fredericks CM (1996). "Disorders of the Cerebellum and Its Connections". In Saladin LK, Fredericks CM (eds.). Pathophysiology of the motor systems: principles and clinical presentations (PDF). Philadelphia: F.A. Davis. ISBN 0-8036-0093-3. Archived from the original (PDF) on 2015-05-13. Retrieved 2016-09-18.
  4. 4.0 4.1 4.2 4.3 4.4 4.5 "Frequently Asked Questions About... Ataxia Classification" (PDF). National Ataxia Foundation. Archived from the original (PDF) on April 18, 2016. Retrieved September 18, 2016.
  5. Spinazzi M, Angelini C, Patrini C (May 2010). "Subacute sensory ataxia and optic neuropathy with thiamine deficiency". Nature Reviews Neurology. 6 (5): 288–93. doi:10.1038/nrneurol.2010.16. PMID 20308997. S2CID 12333200.
  6. "Inadvertent Ingestion of Marijuana --- Los Angeles, California, 2009". Retrieved 3 September 2009.
  7. Browne TR (May 1976). "Clonazepam. A review of a new anticonvulsant drug". Arch. Neurol. 33 (5): 326–32. doi:10.1001/archneur.1976.00500050012003. PMID 817697.
  8. Gaudreault P, Guay J, Thivierge RL, Verdy I (1991). "Benzodiazepine poisoning. Clinical and pharmacological considerations and treatment". Drug Saf. 6 (4): 247–65. doi:10.2165/00002018-199106040-00003. PMID 1888441. S2CID 27619795.
  9. Victor M, Ropper AH, Adams RD, Samuels M (2009). Adams and Victor's Principles of Neurology (Ninth ed.). McGraw-Hill Medical. pp. 78–88. ISBN 978-0-07-149992-7.
  10. Pavan MR, Deepak M, Basavaprabhu A, Gupta A (2012). "Doctor i am swaying – An interesting case of ataxia". Journal of Clinical and Diagnostic Research. Retrieved 2 May 2013.
  11. Díez S (2009). "Human Health Effects of Methylmercury Exposure". Reviews of Environmental Contamination and Toxicology Volume 198. Vol. 198. pp. 111–32. doi:10.1007/978-0-387-09647-6_3. ISBN 978-0-387-09646-9. PMID 19253038. {{cite book}}: |journal= ignored (help)
  12. Pagon RA, Bird TD, Dolan CR, Stephens K, Adam MP, Bird TD (1998). Hereditary Ataxia Overview (last revision 2012). PMID 20301317. {{cite book}}: |work= ignored (help)
  13. Morton SM, Bastian AJ (December 2009). "Can rehabilitation help ataxia?". Neurology. 73 (22): 1818–9. doi:10.1212/WNL.0b013e3181c33b21. PMID 19864635. S2CID 5481310.
  14. Trujillo-Martín MM, Serrano-Aguilar P, Monton-Alvarez F, Carrillo-Fumero R (June 2009). "Effectiveness and safety of treatments for degenerative ataxias: a systematic review". Mov. Disord. 24 (8): 1111–24. doi:10.1002/mds.22564. PMID 19412936. S2CID 11008654.
  15. 15.0 15.1 Perlman SL (November 2006). "Ataxias". Clin. Geriatr. Med. 22 (4): 859–77, vii. doi:10.1016/j.cger.2006.06.011. PMID 17000340.