Ataxia is a group of neurological disorders that causes symptoms like lack of coordination in moving different parts of the body, loss of balance, slurred speech, slow eye movements, and difficulty swallowing.
Ataxia can have various causes, such as neurodegenerative conditions, cerebral palsy, infections, hereditary factors, brain hemorrhages, malformations, and excessive use of drugs or alcohol.
Treatment of ataxia is managed by a neurologist and usually involves the use of medications, physical therapy, speech therapy, and/or occupational therapy to reduce symptoms and improve quality of life.
Common symptoms
The main symptoms of ataxia include:
- Lack of coordination of body movements;
- Loss of balance, which can lead to frequent falls;
- Difficulty picking up objects and buttoning clothes;
- Irregular eye movements;
- Difficulty swallowing or writing;
- Excessive tremors;
- Jumbled or slurred speech.
In cases of chronic ataxia, symptoms like recurrent infections, back problems, and heart disease can also develop due to neurological degeneration.
Ataxia and its associated symptoms can develop at any age and may be present at birth.
Confirming a diagnosis
The diagnosis of ataxia is made by a neurologist based on an evaluation of symptoms, medical history, and a full neurological exam to identify problems with movement, vision, or speech.
A doctor or other healthcare provider may also order imaging or lab tests to identify the cause of the ataxia.
Diagnostic testing
The main tests used to diagnose ataxia are:
- Magnetic resonance imaging (MRI) or computed tomography (CT scan) to identify a brain injury or tumor;
- Blood tests to check for nutritional deficiencies, medications, or toxins;
- Urine tests to check mercury levels;
- Electromyoneurography to assess the nerves and muscles;
- Genetic testing, in the case of hereditary ataxia.
A doctor may also order a lumbar puncture to test for any infections.
Possible causes
The main causes of ataxia are:
- Family history of ataxia;
- Traumatic brain injury;
- Brian tumor or stroke;
- Excessive or frequent consumption of alcohol;
- Exposure to toxic substances;
- Radiation therapy to the brain.
Ataxia can also be caused by deficiencies in vitamins B12, B1, or E; hypothyroidism; infections; antidepressants or antiepileptics; spinocerebellar ataxia type 3 (Machado-Joseph disease); cerebral palsy; or multiple sclerosis.
Ataxia can be caused by abnormalities in different parts of the nervous system, such as the cerebellum, spinal cord, nerves, and nerve roots, affecting movement, eye control, speech, swallowing, and balance.
Different types
The main types of ataxia are:
1. Cerebellar ataxia
Cerebellar ataxia is caused by damage or injury to the cerebellum, a structure in the brain responsible for eye movements, balance, speech, and swallowing.
This type of ataxia can be caused by a brain hemorrhage, tumor, infection, or accident.
2. Friedreich's ataxia
Friedreich's ataxia is the most common type of hereditary ataxia and typically appears during adolescence, causing foot deformities and spinal curvature.
3. Spinocerebellar ataxia
Spinocerebellar ataxia is another type of hereditary ataxia. It typically appears during adulthood and causes muscle stiffness, memory loss, urinary incontinence, and progressive vision loss.
4. Ataxia–telangiectasia
Ataxia–telangiectasia, commonly known as Louis-Bar syndrome, is a rare type of hereditary ataxia that can appear during infancy and develop over time. People with this condition typically present with a weakened immune system.
5. Sensory ataxia
Sensory ataxia is caused by damage to the sensory nerves causing a lack of awareness of where the legs are in relation to the rest of the body.
6. Idiopathic ataxia
Idiopathic ataxia occurs mainly in older adults and is characterized by lack of a clear cause.
Treatment options
Treatment of ataxia is managed by a neurologist and depends on the type and severity of the condition.
The main treatments for ataxia are:
1. Medications
Medications may be prescribed by a doctor to help reduce symptoms.
The most common medications for ataxia include:
- Muscle relaxers, like baclofen and tizanidine, used to treat muscle spasms and stiffness;
- Beta blockers, like propranolol, to reduce tremors;
- Anticonvulsants, like pregabalin or gabapentin, for neuropathic symptoms;
- Adamantanes, like amantadine, to improve motor function.
Medications are prescribed by a neurologist based on the type of ataxia and associated symptoms.
A doctor may also prescribe other medications like antidepressants, immunosuppressants, antibiotics, antivirals, or vitamin supplements depending on the type of ataxia.
2. Physical therapy
Physical therapy exercises are another important part of ataxia treatment that help improve uncoordinated movements and prevent muscle weakness or stiffness.
The number of physical therapy sessions depends on the severity of the condition.
3. Occupational therapy
Occupational therapy is recommended for people with ataxia to help develop independence and adapt to gradual loss of movement by acquiring new skills to perform daily activities.
Occupational therapy can help individuals learn to use assistive equipment like special utensils, walkers, or wheelchairs, for example.
4. Speech therapy
Speech therapy is indicated for the treatment of ataxia to help with speech, eating, and swallowing, and should be guided by a speech language pathologist.
5. Psychotherapy
Psychotherapy typically involves a referral to a psychologist or other mental health professional and is recommended to help people with ataxia and their families better understand the condition.
Cognitive behavioral therapy (CBT) is a tool that is often used to help individuals cope with their emotions and the impact of ataxia on day-to-day life, helping to improve quality of life.
Is ataxia curable?
Ataxia caused by infections or nutritional deficiencies can be cured with proper treatment recommended by medical professionals.
While there is no cure for ataxia caused by genetic mutations, appropriate treatment can help manage the condition and improve quality of life.