Description

Ataxia describes a lack of muscle control that leads to awkward movements. It can affect gait and balance, hand coordination, speech and swallowing, and the movements of the eyes.

Ataxia is usually the result of damage to the part of the brain called the cerebellum or its connections. The cerebellum controls muscle coordination. Many conditions can cause ataxia, including genetic conditions, strokes, tumors, multiple sclerosis, degenerative diseases, and alcohol abuse. Certain medications can also cause ataxia.

The treatment for ataxia depends on the cause. Devices such as walkers and canes may help to maintain independence. These are also called adaptive devices. Physical therapy, occupational therapy, speech therapy, and regular exercise can also help.

Symptoms

The symptoms of Ataxia can develop over time or start suddenly. Ataxia can be a symptom of several diseases of the nervous system. Symptoms may include:

  • Poor coordination.
  • Unsteady walking or with the feet well apart.
  • The lack of balance.
  • Problems with fine motor skills, such as eating, writing or buttoning a shirt.
  • Changes in speech.
  • Back and forth movements of the eyes that can't be controlled.
  • Difficulty swallowing.

When to see a doctor

If you do not already have a condition that causes the ataxia, such as multiple sclerosis, consult your health care professional as soon as possible if you:

  • You lose your balance.
  • To lose muscle coordination in a hand, arm, or leg.
  • You have trouble walking.
  • Ligation of his speech.
  • You have difficulty swallowing.

Causes

The Ataxia is caused by damage to the part of the brain called the cerebellum or its connections. The cerebellum is located at the base of the brain and connects to the brain stem. The cerebellum helps control balance, eye movement, swallowing, and speech.

There are three major groups of causes of ataxia: acquired, degenerative and hereditary.

Acquired causes

  • The consumption of Alcohol. Long-term excessive consumption of alcohol can cause persistent ataxia. Ataxia can improve by staying away from alcohol completely.
  • Drugs. Ataxia is a possible side effect of certain medications. It can be caused by sedatives such as phenobarbital and the benzodiazepines. It can also be caused by anti-epileptic drugs, especially phenytoin. Some types of chemotherapy can also cause ataxia.
  • Toxins. Poisoning by heavy metals, such as lead or mercury, and the poisoning solvents, such as paint thinner, can also cause ataxia.
  • Too little or too much of certain vitamins. Ataxia can be caused by a lack of vitamin E, vitamin B-12 or vitamin B-1, also known as thiamine. Too much or too little of the vitamin B-6 can also cause ataxia. Not getting enough of a particular vitamin is known as a vitamin deficiency. When a deficiency of the vitamin is the cause of ataxia, which can often be reversed.
  • Thyroid conditions. Hypothyroidism and hypoparathyroidism can cause ataxia.
  • Stroke. The sudden onset of ataxia occurs with a stroke. This may be due to a blocked blood vessel or bleeding in the brain.
  • Multiple sclerosis. This condition can cause ataxia.
  • Autoimmune diseases. Several diseases in which the immune system attacks healthy cells, known as autoimmune diseases, can cause ataxia. May include a disease that causes inflammatory cells to collect in the parts of the body, known as sarcoidosis. Or you can include a disease caused by an immune reaction to eating gluten, known as celiac disease. Ataxia can also be caused by certain types of a condition that results in inflammation of the brain and spinal cord, called encephalomyelitis.
  • Infections. Rarely, ataxia can be a symptom of chickenpox in children, and other viral infections such as HIV and Lyme disease. It might appear in the healing stages of the infection and last for days or weeks. The symptoms usually improve with time.
  • COVID-19. The Ataxia may be the result of a severe infection with the virus that causes COVID-19 .
  • Paraneoplastic syndromes. These are rare degenerative disease that is triggered by an immune system response to a cancerous tumor, known as a neoplasm. Paraneoplastic syndromes occur with increased frequency of lung, ovarian or breast cancer or lymphoma. The Ataxia may appear months or years before the cancer is diagnosed.
  • The changes in the brain. An infected zone in the brain, known as an abscess, it can cause ataxia. And a growth in the brain, like a cancer or benign tumor, can cause damage to the cerebellum.
  • Trauma to the head. The brain damage can cause ataxia.
  • The Cerebral palsy. This is a general term for a group of diseases caused by damage to the brain of a child. The damage can occur before, during, or shortly after birth. Affects the child's ability to coordinate body movements.

Degenerative causes

  • The multiple system atrophy. This rare disease affects the movements and functions such as blood pressure. May cause ataxia and other symptoms, such as lack of bladder control, fainting after standing up and behavior of sleep condition in which a person acts out the dreams.

Hereditary causes

Some types of ataxia, and some conditions that cause ataxia are transmitted in families. These conditions are also called hereditary. If you have any of these conditions, you may have been born with a genetic change that causes the body to produce irregular proteins.

The irregularity of the proteins affect the function of the nerve cells, mainly in the cerebellum and the spinal cord. Cause the nerve cells break down and die, known as degeneration. As the disease progresses, the coordination problems get worse.

People with a genetic ataxia may have inherited a dominant gene from one parent, is known as an autosomal dominant pattern of inheritance. Or they may have inherited a recessive gene from both parents, known as a pattern of inheritance was autosomal recessive. In a recessive condition, the parents are not affected, but that the siblings may be affected.

Different changes in genes cause different types of ataxia. Most types worsen with time. Each type causes poor coordination, but it also has other specific symptoms.

The ataxia autosomal dominant

  • Spinocerebellar Ataxias. Researchers have identified more than 40 spinocerebellar ataxia genes, and the number continues to grow. The Ataxia and cerebellar degeneration are common to all types, and there may be other symptoms.
  • Episodic ataxia (EA).There are eight recognized types of episodic ataxia. The typesEA1 andEA2 are the most common.EA1 involves brief episodes of ataxia that can last seconds or minutes. The attacks are triggered by stress, sudden movement or startle. They are often associated with muscle contraction. EA2 involves more episodes of ataxia, which can last anywhere from 30 minutes to six hours. These episodes are also caused by stress. Dizziness and muscle weakness can occur. The people withEA2 you may feel very tired. Sometimes the symptoms are resolved later in life. Episodic ataxia does not shorten the useful life and the symptoms may respond to the medicine.

Episodic ataxia (EA). There are eight recognized types of episodic ataxia. Types EA 1 and EA 2 are the most common. EA 1 involves brief episodes of ataxia that can last seconds or minutes. The attacks are triggered by stress, sudden movement or startle. They are often associated with muscle contraction.

EA 2 involves more episodes of ataxia, which can last anywhere from 30 minutes to six hours. These episodes are also caused by stress. Dizziness and muscle weakness can occur. Persons with AD 2 you may feel very tired. Sometimes the symptoms are resolved later in life. Episodic ataxia does not shorten the useful life and the symptoms may respond to the medicine.

Autosomal recessive ataxias

  • Friedreich's ataxia.This is the most common hereditary ataxia. This implies a damage in the cerebellum, spinal cord, and peripheral nerves. The peripheral nerves carry signals from the arms and legs to the brain and the spinal cord. The symptoms usually appear well before the age of 25. An exploration of the brain that usually do not show changes in the cerebellum with this type of ataxia. The first symptom of Friedreich's ataxia is often difficulty walking. The condition usually is going to affect the arms and the trunk. This type of ataxia can cause changes in the feet, such as high arches. It can also cause a curvature of the spine, known as scoliosis. Other symptoms that may develop include slurred speech, fatigue, irregular eye movements, and loss of hearing. Friedreich's ataxia can also lead to increased size of the heart, known as cardiomyopathy. Heart failure and diabetes may also occur. The early treatment of heart disease, can improve the quality of life and survival.
  • RFC1 associated with ataxia. This is the most common cause of ataxia that happens later in life. The ataxia symptoms typically present with dizziness and a sensation of numbness or tingling in the body. Sometimes this type of ataxia causes of cough.
  • The Ataxia-telangiectasia.This rare childhood disease causes degeneration in the brain and the immune system. This increases the risk of other diseases, including infections and tumors. Telangiectasia is the formation of small red "spider" veins that can appear in the corners of the eyes of a child or in the ears and cheeks. Delayed development of motor skills, balance problems and difficulty in speech are often the first symptoms. Frequent sinusitis, and respiratory infections are common. Children with ataxia-telangiectasia are at high risk of developing cancer, especially leukemia or lymphoma.
  • Congenital cerebellar ataxia. This type of ataxia results from damage to the cerebellum, which is present at birth.
  • Wilson's disease. In people with this condition, the copper builds up in the brain, liver, and other organs. This can cause ataxia, and other symptoms.

Friedreich's ataxia. This is the most common hereditary ataxia. This implies a damage in the cerebellum, spinal cord, and peripheral nerves. The peripheral nerves carry signals from the arms and legs to the brain and the spinal cord. The symptoms usually appear well before the age of 25. An exploration of the brain that usually do not show changes in the cerebellum with this type of ataxia.

The first symptom of Friedreich's ataxia is often difficulty walking. The condition usually is going to affect the arms and the trunk. This type of ataxia can cause changes in the feet, such as high arches. It can also cause a curvature of the spine, known as scoliosis.

Other symptoms that may develop include slurred speech, fatigue, irregular eye movements, and loss of hearing. Friedreich's ataxia can also lead to increased size of the heart, known as cardiomyopathy. Heart failure and diabetes may also occur. The early treatment of heart disease, can improve the quality of life and survival.

The Ataxia-telangiectasia. This rare childhood disease causes degeneration in the brain and the immune system. This increases the risk of other diseases, including infections and tumors.

Telangiectasia is the formation of small red "spider" veins that can appear in the corners of the eyes of a child or in the ears and cheeks. Delayed development of motor skills, balance problems and difficulty in speech are often the first symptoms. Frequent sinusitis, and respiratory infections are common.

Children with ataxia-telangiectasia are at high risk of developing cancer, especially leukemia or lymphoma.

Risk factors

There are several risk factors for ataxia. People who have a family history of ataxia are at a higher risk of having the ataxia of themselves.

Other risk factors include:

  • Drinking too much alcohol over a long period.
  • Having hypothyroidism or hypoparathyroidism.
  • Multiple sclerosis.
  • To have a disease caused by an immune reaction to eating gluten, known as celiac disease.
  • Have a disease that causes inflammatory cells to accumulate in the parts of the body, known as sarcoidosis.
  • Have a degenerative disease called multiple system atrophy.
  • Have a paraneoplastic syndrome caused by the cancer.
  • Taking medications that increase the risk of ataxia, such as anti-seizure medications, and sedatives.
  • Be exposed to heavy metals, such as lead or mercury, or solvents, such as paint thinner.
  • Not getting enough vitamin E, vitamin B-6, vitamin B-12 or vitamin B-1, also known as thiamine. Too much vitamin B-6 is also a risk factor.

Diagnosis

When the diagnosis of ataxia, your health care professional to look for a treatable cause. It is likely that you will have physical and neurological exams. Your health care professional checks your vision, balance, coordination, and reflexes. You may also need:

  • Blood tests. These can help you find the treatable causes of ataxia.
  • The imaging studies. An mri of the brain can help to find the possible causes. An mri can sometimes show the shrinkage of the cerebellum and other brain structures in people with ataxia. You can also display other treatable findings, such as a blood clot or benign tumor.
  • A lumbar puncture, also known as a lumbar puncture. This test can be useful if an infection, swelling, also called the inflammation or certain diseases could be the cause of ataxia. A needle is inserted into the lower part of the back between the two bones to remove a small sample of cerebrospinal fluid. The fluid that surrounds and protects the brain and spinal cord, is sent to a laboratory for analysis.
  • The genetic testing. Your health care professional may recommend genetic testing to see if a change in the gene can be the cause of a condition that leads to ataxia. Genetic tests are available for many, but not all, of the hereditary ataxias.

Treatment

The Ataxia of treatment depends on the cause. If the ataxia is caused by a medical condition, such as vitamin deficiency or celiac disease, the treatment of the disease can help to improve the symptoms. If the ataxia results of chickenpox or other viral infections, it is likely to resolve on its own.

People with Friedreich's ataxia can be treated with an oral medication called omaveloxolone (Skyclarys). The united states Food and Drug Association approved the drug for adults and adolescents over 16 years. In clinical trials, taking the medication to improve symptoms. People who take this drug need blood tests because omaveloxolone can affect the liver enzyme, and cholesterol levels. The possible side effects of omaveloxolone, which include headache, nausea, stomach pain, fatigue, diarrhea, and muscle and joint pain.

Symptoms such as rigidity, tremors, and dizziness may be enhanced by other medicines. Your healthcare provider may also recommend adaptive devices or therapies.

Adaptive devices

The Ataxia is caused by conditions such as multiple sclerosis or cerebral palsy may not be treatable. But adaptive devices can help. They include:

  • Hiking sticks or walkers to walk.
  • Modified eating utensils.
  • Communication aids to speak.

Therapies

You can benefit from certain therapies, including:

  • Physical therapy to help with coordination and improve mobility.
  • Occupational therapy to help with everyday tasks such as feeding.
  • Speech therapy to improve speech and swallowing.

Some studies have found that aerobic exercise and strength exercises may be beneficial for some people with ataxia.

Coping and support

Living with ataxia or having a child with the condition can be a challenge. For some people, having the ataxia can lead to depression and anxiety. Speak with a counselor or therapist can help. Join a support group for ataxia or a condition that causes the ataxia can provide information and support.

Support group members often know about the latest treatments and they tend to share their own experiences. Your health care professional may be able to recommend a group in your area.

Preparing for your appointment

It is likely to start by seeing your health care professional. You may be referred to a neurologist.

Here's some information to help you prepare for your appointment.

What you can do

When you make the appointment, ask if there is something that you need to do in advance, such as fasting before a specific test.

Make a list of:

  • Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began.
  • Key personal information, including other conditions you have and the family medical history.
  • All medications, vitamins or supplements that you take, including over-dose.
  • Questions to ask your health care professional.

Have a friend or family member, if possible, to help you remember the information that is obtained.

For ataxia, basic questions to ask include:

  • What is likely causing my symptoms?
  • Other that the most likely cause, what are other possible causes?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • There are devices that can help me with the coordination?
  • I have other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?
  • Do you know of ataxia research studies in which they could participate?

Do not hesitate to ask other questions.

What to expect from your doctor

Your healthcare provider is likely to ask you questions, such as:

  • When did the symptoms begin?
  • What was your first symptom?
  • Do you notice that your symptoms all the time, or every once in a while?
  • What appears to improve the symptoms?
  • What seems to make your symptoms worse?
  • Do you have family members who have had these types of symptoms?
  • Make use of alcohol or drugs?
  • Have you been exposed to toxins?
  • Have had an infection with a virus recently?

What you can do in the meantime

Do not drink alcohol or take legal or illegal drugs that can be sold on the street, also called recreational drugs, which can cause ataxia worse.

Symptoms and treatment of Ataxia