Respected sir, my father is 59 years old suffering from spinocerebellar ataxia. Progressive in nature. 1. Slurring of speech since 2007 2. Gait abnormality since 2009 3. Writing abnormality since 2009 he is not having any comorbidities neither any family history. Please help me if you have any suggestion for him.

Dr. Rajshekher GarikapatiNeurologist19yrs exp

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Progressive sca at 59 years age is unusual and should trigger a search for various conditions: cerebrovascular disease, demyelinating disease, infectious diseases, vitamin deficiency, toxic exposure, sarcoidosis, autoimmune diseases (eg, sle, sjogren syndrome), and alcohol-induced cerebellar degeneration. Other diseases that can mimic this condition include late-onset spinocerebellar ataxia with or without a family history, olivopontocerebellar degeneration, and other degenerative diseases of the brain. The most problematic is paraneoplastic cerebellar degernation, even though it is slightly more common among women; in men, it may signal an occult small cell ca of the lung, or hodkgin lymphoma. Apart from the tests for the other conditions mentioned, a test for anti-yo antibody and a search for occult malignancy should be done. Treatment is by physiotherapy/gait therapy, and treatment for the underlying condition if possible. 

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