Ataxia

What is ataxia?

 

Ataxia is when a person has difficulty with coordination, which results in them moving in an uncertain, awkward, or clumsy manner. It is a degenerative disease of the nervous system, affecting the part of the brain controlling an individual’s ability to move their eyes or use their:

  • Fingers and hands
  • Arms
  • Legs

Ataxia can affect people at any age and can be severe, but there are treatment options. Monitor yourself or a loved one for any symptoms. If you notice any changes, make sure to schedule an appointment with your healthcare provider to discuss the best options and if you need to go to a specialist.

What are the symptoms of ataxia?

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There are a range of possible ataxia symptoms based on the individual and type of ataxia. The speed at which the disease progresses is different for each person. Progression can be slower, worsening over decades, or quicker and more severe over months.

Symptoms may include:

  • Slurred speech
  • Trouble eating and swallowing
  • Lack of coordination
  • Difficulty walking
  • Gait abnormalities
  • Deteriorating fine motor skills
  • Tremors
  • Vision changes
  • Eye movement abnormalities (back-and-forth movements)
  • Heart problems

Ataxia is common as a symptom but less common as a condition. The disease as a condition typically occurs in tandem with specific genetic conditions and diseases. Ataxia can refer to a group of diseases as well.

What is the difference between ataxia and apraxia?

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Despite some similarities, the differences between ataxia and apraxia are distinct.

Ataxia

  • A symptom that causes issues with coordinating muscle movements
  • Affects all actions (new or familiar)
  • The brain can still process or describe the tasks

 

Apraxia

  • A condition that affects the brain
  • Makes it difficult to do or describe familiar actions
  • The brain cannot process the actions

 

Speaking to a doctor and even getting multiple opinions is the best way to ensure a proper diagnosis. Once you receive that diagnosis, you will be one step closer to the best possible treatment option.

How is ataxia diagnosed?

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A doctor will diagnose ataxia by utilizing a person’s medical history and family history, plus doing a complete neurological evaluation. Your doctor may run specific blood tests to rule out specific disorders. Genetic blood tests can be run to help diagnose hereditary ataxia in patients.

What can cause ataxia?

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Damage to the brain’s cerebellum or its connections can cause ataxia. The cerebellum is found at the base of the brain and is connected to the brainstem. The three main ataxia causes are:

  • Acquired
  • Degenerative
  • Hereditary

 

Acquired Ataxia Causes

  • Long-term and excessive alcohol use
  • Sedatives (phenobarbital and benzodiazepines)
  • Anti-seizure medicine (phenytoin)
  • Chemotherapy
  • Heavy metal poisoning (lead or mercury)
  • Solvent poisoning (paint thinner)
  • Vitamin deficiency (vitamins E, B-12, B-1) or out-of-range B-6 levels
  • Hypothyroidism or hypoparathyroidism
  • Stroke
  • Autoimmune diseases (sarcoidosis, celiac disease, encephalomyelitis)
  • Multiple sclerosis
  • Infections (HIV and Lyme disease)
  • An infection with the virus causing COVID-19
  • Paraneoplastic syndromes
  • Head trauma
  • Sudden brain changes (abscess, or cancerous/noncancerous tumors)
  • Cerebral palsy

 

Degenerative Ataxia Causes

 

Multiple system atrophy is a rare condition that affects a person’s movements and functions. Blood pressure is one function that may be affected. Multiple system atrophy can cause the following symptoms:

  • Ataxia
  • Lack of bladder control
  • A sleep behavior condition where you act out dreams
  • Fainting after standing

 

Hereditary Ataxia Causes

An individual can be born with a genetic change causing the body to produce irregular proteins. These irregular proteins cause nerve cells to break down and die, or degenerate, mostly in the cerebellum and spinal cord. Coordination problems worsen as the disease progresses.

Genetic ataxia can be inherited through:

  • A dominant gene from one parent (autosomal dominant inheritance pattern)
  • A recessive gene from both parents (autosomal recessive inheritance pattern)

The type of ataxia is determined by the specific gene changes. Most will worsen with time.

What are the types of ataxia?

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The three main types of ataxia, occurring in different ways, are:

  • Cerebellar: The cerebellum controls how different parts of the brain work together

 

  • Sensory: Disrupting the brain’s ability to track the location of each body part, even without seeing them
  • Vestibular: Having a problem with your inner ears will disrupt your balance and affect your coordination

When you speak with a doctor, make sure to describe or bring with you someone who can detail all of your symptoms.

How is ataxia treated?

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The way that your doctor will recommend you treat ataxia depends on its cause. You may not require long-term treatment if you have temporary causes, such as:

  • Alcohol intoxication
  • Fatigue
  • Stress-induced ataxia

A cause that may only require minor treatments is a vitamin B-12 deficiency. A doctor may just recommend taking vitamin supplements. There are off-label medications used to treat common symptoms that are linked to ataxia as well. A healthcare provider is the best person to tell you about treatment options and which one will prove most effective for your particular diagnosis.

When should ataxia be treated by a doctor?

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Never ignore the warning signs of ataxia. Seeking medical attention may reveal that there is a more severe problem in need of treatment. Contact your healthcare provider immediately if:

  • Ataxia happens suddenly or is getting worse
  • Ataxia occurs with symptoms like headaches, nausea, or vomiting
  • Your symptoms last for more than a few days
  • Ataxia coincides with stroke symptoms
  • You have trouble swallowing, speaking, or controlling eye movement
  • Ataxia interferes with your activities or routine

For immediate medical emergencies, call 911 and go to the hospital.

How should you prepare for a doctor’s appointment?

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One way to reclaim some autonomy is by taking an active role in your care or bringing a loved one if you require an advocate. A neurologist will have the expertise to answer your questions. You should gather some information before attending a doctor’s appointment, including:

  • A list of general health exams
  • Any current medications
  • Records of past medical test results (MRIs or CT scans of the brain)
  • Genetic testing reports
  • Biological family health history
  • Details on symptom progression and severity
  • Questions and/or concerns

What is the outlook for someone with ataxia?

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Ataxia can affect a person’s life in many different ways in both the short and long term. Ataxia can, but will not necessarily, affect a person’s lifespan depending on why it is happening. The causes that are curable, reversible, or temporary will likely not affect how long you live.

Other causes of ataxia can result in major lifestyle impacts and changes. People with ataxia may need to use a:

  • Wheelchair
  • Walker
  • Scooter

Whether ataxia affects how you participate in activities or has more severe consequences, there is support available. Your healthcare provider is the best person to give you a detailed prognosis that will inform your future decisions.

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