Ataxia is diagnosed on the basis of review of symptoms and family history, and neurological evaluation. Symptoms of ataxia varies with the type.
There are three broad categories of ataxia
acquired,
hereditary,
idiopathic late-onset cerebellar ataxia (ILOCA).
Treatment depends on the cause of ataxia. Supportive devices are suggested to improve the symptoms of the condition and also the quality of life of the person.
Symptoms vary with the type and severity of Ataxia.
Symptoms of ataxia caused by an underlying condition may appear at any age. The initial symptoms of ataxia include poor coordination of limbs and slurred speech.
Patients often find it difficult to control volume and pitch of the sound.
Advanced symptoms of ataxia include
Difficulty in swallowing
Vague facial expressions
Tremors
Rapid, repetitious movement of eye
High arch of foot
Cold feet
Difficulty in balancing
Vision and hearing problems
Depression
In cerebellar ataxia, small veins may appear around the eyes and ears.
Friedreich's ataxia is characterized by curvature of the spine and cardiomyopathy.
3 Causes
Damage or degeneration of the nerve cells in the cerebellum causes ataxia.
Some of the causes of ataxia are given below.
Damage of brain or spinal cord due to trauma, as in an accident, leads to sudden onset of ataxia. This condition is known as acute cerebellar ataxia
Death of brain cells due to lack of enough oxygen or nutrients as in stroke also leads to ataxia
A temporary reduction in the blood flow to brain due to transient ischemic attack (TIA) causes ataxia
Brain damage during development causes cerebral palsy, one of the causes of ataxia
Multiple sclerosis affects different part of brain including the regions controlling voluntary movements
Ataxia is one of the complication of chicken pox and other viral infections
Paraneoplastic syndromes, disorders caused by the reaction of immune system to tumor, also cause ataxia
Cerebellar tumor damages the region controlling voluntary movements
Certain medications like barbiturates and sedatives may cause ataxia as a side effect
Deficiency of vitamin B-12 also may result in this condition
In some cases, no specific cause can be implied in the development of this disorder and is known as sporadic degenerative ataxia.
Certain genetic defects are also known to cause this condition. The abnormal proteins produced by the defective gene affect the function of nerve cells resulting in their degeneration.
Hereditary or genetic form of ataxia may be produced by autosomal dominant or autosomal recessive disorder.
Spinocerebellar ataxias and episodic ataxia are autosomal dominant ataxias.
Friedreich's ataxia,
congenital cerebellar ataxia,
ataxia-telangiectasia,
Wilson disease
are inherited as autosomal recessive forms.
4 Making a Diagnosis
Diagnosis of ataxia is based on physical examination, review of symptoms, and neurological evaluations.
Neurological examination assesses
vision,
memory,
concentration,
hearing,
balance,
coordination and reflexes.
Imaging studies like CT scan and MRI help to detect and locate the abnormalities in brain. A spinal tap or lumbar puncture also is recommended to diagnose the cause of ataxia.
In this procedure, the cerebrospinal fluid sample is removed from the lower back by inserting a needle between the two lumbar vertebrae.
Gene mutations that cause ataxia are detected using genetic testing.
There is no complete cure for Ataxia, however, there are treatments that can alleviate symptoms.
Ataxia caused by underlying conditions resolve when the condition is treated successfully. Treatment helps to improve the quality of life by using supportive and assistive devices.
Adaptive devices like
walkers,
modified vessels for eating
communication aids for speaking
are of help.
Physical therapy is recommended to improve the strength and flexibility of the muscles.
Occupational therapy helps the person to carry on with daily routine, while speech therapy is helpful in improving speech.
Muscle spasms and uncontrolled movements of eyes are controlled by medications.
6 Prevention
There is no standard way to prevent ataxia.
Preventing or treating the medical conditions that cause ataxia may be of help.
7 Alternative and Homeopathic Remedies
Homeopathic remedies used for treatment of locomotor ataxia are:
Argentum nitricum,
alumina,
secale cornutum,
silicea.
Biofeedback and ayurveda are used in treatment of ataxia to improve coordination and balance.
Vitamin E and Acetyl-dl-leucine supplementation are also suggested in treating specific symptoms of ataxia.
8 Lifestyle and Coping
Lifestyle modifications are necessary in order to cope with ataxia.
The loss of independence due to ataxia often leads to anxiety.
Counseling and therapy help to cope with the situation.
Joining a support group for ataxia or for the underlying medical condition, like tumor or multiple sclerosis, also may be of help.
These groups are good sources of information and a good platform for sharing experiences.
9 Risk and Complications
Symptoms of ataxia may become permanent in many people, particularly in acute cerebellar ataxia.
Anxiety and depression are also complications of ataxia.
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