Question

Ataxia - Know More About It!

Dr.Radhika A (Md) · Accepted Answer

Ataxia-
The muscle coordination in the body will perform crucial functions. A perfect coordination is required to deliver a speech, walk, move, swallow food, drink water and pick up objects. You will be able to perform various kinds of voluntary movements if there is perfect coordination of muscles. There are many causes which lead to Ataxia which include head trauma, stroke, alcohol abuse, tumour and multiple sclerosis. As there are many types of Ataxia, the doctor will figure out the type after the diagnosis and right kind of treatment will be offered to the patient.

It is crucial to figure out the type of ataxia. If there is a loss of balance and coordination, there will be great difficulty in performing the day-to-day activities. After diagnosing the cause, the patient should implement the course of action as suggested by the doctor. The patient should get support from family members and associates so that there will be a quick recovery.

Causes of Ataxia-
- There are wide ranges of factors that lead to Ataxia. Some people are born with Ataxia while others develop it gradually.

- Some people are affected by Ataxia after a stroke, brain tumour, head injury, multiple sclerosis and excess alcohol consumption.

- Ataxia can become severe over a period of time. However, it can stabilize and the stability is based on the cause.

- Cerebellar ataxia is a common form of Ataxia. Cerebellum will combine the sensory perception, motor control and coordination. If there is dysfunction of the cerebellum, it will lead to Ataxia.

- The assimilation of sensory perception, motor control and coordination will take place in the brain s region called the cerebellum.

- The neurological abnormalities will take place with the vitamin B-12 deficiency. There will be overlapping of cerebellar and sensory ataxia.

- There will be changes in the behaviour and personality when you are affected with the ataxia. The changes in voice and muscle tone will take place gradually.

Symptoms of Ataxia-
- People suffering from Ataxia will witness poor coordination and they fail to lift objects successfully.

- If a person is suffering from cerebellum Ataxia, it will lead to neurological issues.

- The neurological issues associated with cerebellum ataxia include floppiness, lack of coordination between organs, limbs, muscles and joints.

- The patient will not have the ability to control distance, power, the speed of the arm, hand, leg and eye movement.

- There will be difficulty in estimating the passage of time as well.

- The patient will fail to perform activities at a rapid phase and in an alternate manner.

- The symptoms of ataxia are based on the parts that are in the cerebellum. There is the probability of occurrence of lesions on either sides or one side.

- If there is damage of vestibulocerebellum, the person will lose balance and there will be an impact on the eye movement as well. A person might want to stand a foot apart (between legs) to hold items and avoid swaying backwards or forward.

- The patient fails to maintain the balance when the feet are together and the eyes are open.

- If the spinocerebellum is affected, there will be unusual gait and there will be difficulty in stepping. The patient finds it difficult to step and there will be sideways steps, unequal steps and stuttering starts and stops. The body and limb movements are regulated by spinocerebellum.

- If there is the impact on cerebrocerebellum, there will be issues with voluntary and planned movements. There will be difficulty in head, eyes, limbs and torso while making voluntary movements. With slurred speeches, there will be variation in rhythm and loudness.

- Patients affected by sensory ataxia will suffer from the loss of proprioception. Proprioception is nothing but the sense of the relative position of the neighbouring parts of the body. You will get a sense whether the body is moving as per the effort exerted by the person. It will also give a feedback on the current position of body parts in relation to the other.

- If a person is suffering from sensory ataxia, there will be an unsteady stomping gait. The heel will strike hard while touching the ground with each step.

- If a person walks in poor lighting conditions, there will be postural instability.

- The instability will worsen while standing with close feet and closed eyes. With the loss of proprioception, there will more dependence on visual data.

- With vestibular ataxia, the vestibular system will be affected. In acute cases, the patient will experience nausea, vomiting and vertigo. If there are slow-onset chronic bilateral cases, the patient will experience unsteadiness.

- If the ataxia takes place due to injury or health condition, the symptoms will appear at any age. The symptoms will improve on their own without any treatment. The initial ataxia symptoms include poor limb coordination and dysarthria. There will be slow and slurred speech which cannot be produced very easily. There will be difficulties in controlling the volume, pitch and rhythm.

- In severe vestibular ataxia, there will be difficulty in swallowing. Coughing and choking symptoms are very common. You can find the change in facial expressions. There will be issues such as walking difficulty, vision and hearing issues and imbalance.

- The cerebral ataxia will occur between 4 years and 26 years. There will be less severe symptoms compared with acute ataxia.

- There will be the appearance of small veins around the eyes, cheeks and ears. The patient may experience delayed physical and sexual development. It will weaken the heart muscle. Diabetes, high arching feet and scoliosis are the symptoms of Friedreich s ataxia.

- The doctor should differentiate the symptoms of ataxia from other conditions. In addition to normal physical check-up, various kinds of tests are performed to assess the condition of the patient.

Diagnosis of Ataxia-
- The doctor will suggest several tests to diagnose the disorder. In addition to physical examination, neurological tests will be conducted to figure out the issue.

- The tests are performed to find out the hearing, memory, balance & walking, vision, concentration, reflexes and coordination.

- The symptoms are evaluated by conducting a number of tests.

- Nerve conduction study The functioning of nerves will be studied by the nerve conduction study.

- EMG Electromyogram will record and evaluate the electrical activity in muscles.

- The cerebrospinal fluid surrounding the spinal cord and brain will be measured with the spinal tap.

- The rise or fall of blood cells will be evaluated with the complete blood count test. The overall health assessment will be done with the blood test.

- CT or MRI scan will help in the assessment of the brain damage through the images. Pictures of the brain will be taken at various angles so that closer look and evaluation will be done.

- The doctor may perform a urine analysis and ultrasound test as well.

Treatment of Ataxia
- Generally, ataxia is not curable. The purpose of the treatment is to improve the symptoms and it will improve the quality of life.

- By using adaptive devices, the treatment will address coordination and balance issues. The patient will be independent after undergoing the treatment.

- The support will be provided by using cane stick, walker, crutches and wheelchair.

- By undergoing the physical therapy, the symptoms such as insomnia, depression, sadness, anger and muscle weakness will be addressed.

- There will be the management of things at home and office after undergoing the occupational therapy.

- The speech therapy will address the speech issues, choking, coughing, and swallowing. If there are speech-related issues, the speech therapist will help the patient in using the speech aids.

- The curvature of the spine can be treated with the orthopaedic care.

- There will be an improvement in the strength and mobility after the physical therapy.

- The frustration and depression can be handled by the counselling. These are the symptoms which may arise due to physical immobility and coordination.

- By taking special diet and vitamin supplements, it is possible to overcome the ataxia. If there is vitamin E deficiency, it should be addressed in the best possible way.

- By offering the gamma-globulin injections, ataxia telangiectasia can be treated.

- Various kinds of drugs are available to deal with muscle spasm and uncontrollable eye movements.

- The treatment for ataxia is dependent upon the cause. The treatment period varies from few weeks to few months. In some case, a lifelong management of the condition is necessary. The caretaker should have the patience to bring the best changes in the patient.

Complications of Ataxia-
- If there is bleeding in the cerebellum, you should undergo the surgery.

- If you are suffering from an infection, antibiotics will be prescribed by the doctor.

- The stroke that led to ataxia will be treated by using blood thinners.

- By using steroids, the inflammation of the cerebellum will be treated in a very efficient manner.

- The exposure to toxin should be eliminated if toxins are the reason for the ataxia.

- Blood loss in the brain, tumour in the brain, chickenpox, reaction to certain cancers, vitamin E and B12 deficiency will increase the risk of ataxia.

- If you have not inherited ataxia, illness or injury will lead to ataxia. The condition is called idiopathic ataxia. If there is no other medical reason, the doctor will diagnose the idiopathic ataxia. Combination of environmental factors as well as genetic causes will affect the condition.

Prevention of Ataxia
- Ataxia can be inherited or non-inherited. If it is a genetic defect, the inheritance will take place from either mother or father. It is a health condition which can pass on from one generation to another generation. The severity may decrease from one generation to another generation. In some cases, the condition will weaken with the increase in age.

- To rule out the genetic forms of ataxia, genetic testing should be done. However, it is not possible to trace all genetic forms of ataxia.

- By maintaining a healthy lifestyle, it is possible to prevent ataxia to some extent. You should be able to deal with the stress so that there will not be the impact on the brain.

- By taking nutritious food, the condition can be avoided or managed in the best possible way.

- Counselling, support groups and speech therapy will help in improving the condition in the best possible way.

Myths of Ataxia
Myth #1. Treatment is must to overcome ataxia

treatment for acute ataxia is always not necessary. If the virus is the cause of acute ataxia, it is possible to achieve full recovery without treatment. The viral acute cerebellar ataxia will subside in a few weeks. However, you should undergo the treatment if the virus is not the cause of ACA.

Myth #2. You will get ataxia due to reaction

There are various reasons to be affected by ataxia. Some people may be affected by ataxia due to certain medications. Prolonged usage of drugs, alcohol and medications will also have a negative impact on the health.

Myth #3. Acute ataxia can be treated

If you are suffering from acute ataxia, it can turn into chronic due to other complications. The complications such as stroke, infection and bleeding in the brain will have a severe impact on your health.

Myth #4. Laboratory tests are not required -

To find out the toxins, the physician may recommend lumbar puncture in which case electrolyte and chemical abnormalities will be found in a very efficient manner.

Conclusion-
The movement disorder is called Ataxia and it will surface if there is a problem in the brain. There are various types of ataxia. You will want to move the muscles in your arms or legs and they will not move. The doctor will assess the condition through the physical examination and other kinds of tests. Non-invasive tests are performed to diagnose the cause and the condition can be managed through the treatment. It will take time to assess the condition of the patient. The most appropriate treatment will be suggested by the doctor to overcome the condition. It may take a few weeks to a few months to overcome the condition. In some cases, it will take many years.

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