Ataxia

Ataxia is a loss of muscle control. People with ataxia lose muscle control in their arms and legs. This may lead to a lack of balance, coordination, and trouble walking. Ataxia may affect the movements of:

• Fingers.
• Hands.
• Arms.
• Legs.
• Body.
• Eyes.

It can also affect the muscles that are used for speech.

Many things can cause the symptoms of ataxia, including:

• Stroke.
• Multiple sclerosis.
• Tumors.
• Alcoholism.
• Nerve damage.
• Metabolic disorders.
• Low levels of some vitamins.
• Immune system problems that attack the brain.

In these cases, treating the condition that caused ataxia may improve it.

The word ataxia usually describes symptoms. But it also describes a group of certain degenerative diseases of the central nervous system. These are:

• Hereditary ataxia. This type is caused by a defect in a gene that a person is born with. Hereditary ataxia may progress over a number of years. How severe the disability is depends on the type of ataxia, the age when the symptoms start, and other factors. Some types of hereditary ataxia start in childhood. Others start in the adult years.
• Sporadic ataxia. This type usually starts in adulthood. It has no known family history.

With hereditary ataxia, a defective gene makes abnormal proteins. These cause nerve cell damage and lead to ataxia. As the disease gets worse, muscles react less and less to the commands of the brain. This causes balance and coordination to get worse over time.

Symptoms and when they start may vary depending on the type of ataxia. The most common symptoms include:

• Balance and movement problems (affected first).
• Poor movement of hands, arms, and legs.
• Slurring of speech.
• Wide-based gait when walking.
• Trouble writing and eating.
• Slow eye movements.

The symptoms of ataxia may look like other conditions or medical problems. Make sure to see your healthcare provider for a diagnosis.

Your healthcare provider will ask about your medical history and your family’s medical history. You will also have a neurological and physical exam. And you may have tests such as:

• Lab tests. These include blood and urine tests.
• Genetic tests. Tests done to see if a person has certain gene changes (mutations) or chromosome changes that are known to increase risk for some inherited conditions
• MRI. This is a test that uses large magnets, radio waves, and  a computer to make detailed images of organs and structures in the body

These tests may also be used to look for other conditions that can cause ataxia to start suddenly. Certain conditions can cause ataxia to develop suddenly. These include:

• Head injury.
• Stroke.
• Brain hemorrhage.
• Infections.
• Exposure to certain drugs.
• If the heart or breathing slows or stops.

Some conditions can cause ataxia to appear slowly. These include:

• Hypothyroidism.
• Alcohol abuse.
• Low levels of some vitamins.
• Chronic exposure to certain drugs.
• Multiple sclerosis.
• Other disorders.

There is no cure for hereditary ataxia. But treatments can help with managing symptoms. And treating other causes of ataxia can help reduce symptoms.

If ataxia is caused by a low vitamin level or contact with a toxic drug or chemical, then treatment with the vitamin or removal of the offending drug can reduce the ataxia.

If the ataxia is caused by your immune system attacking the brain, you may have treatments to suppress your immune system. Looking for and treating the cause of the immune defect (such as a tumor in the body) can also improve the symptoms.

The treatment for the lack of coordination or imbalance is mostly done with the use of adaptive devices. These can help you to be as independent as possible. These devices may include a cane, crutches, a walker, or a wheelchair. Physical therapy, speech therapy, and medicines can help lessen symptoms. These can help with tremor, stiffness, depression, spasticity, and sleep disorders.

Research is being done on cerebellar and spinocerebellar degeneration. This includes work to find the causes of ataxias and ways to treat, cure, and prevent them.

Each type of ataxia may progress differently. Falling or becoming chair- or bed-bound may lead to injury, pressure sores, infection, and blood clots. Dementia, behavioral problems, and depression may affect care. Other complications of ataxia may include:

• Dizziness.
• Spasticity.
• Rigidity.
• Tremor.
• Pain.
• Fatigue.
• Low blood pressure with sitting or standing.
• Bowel or bladder dysfunction.
• Sexual dysfunction.

In severe cases, a person may have rigidity that is not treatable, breathing trouble, or choking which can lead to death. Some of the most difficult symptoms need to be managed with special care. These may include a continuous positive airway pressure device (CPAP), tracheostomy, or a feeding tube. Many things can be done to improve the quality of life of the person with ataxia.

Contact your provider if you have any of the following symptoms:

• Balance and movement problems.
• Lack of muscle control in hands, arms, or legs.
• Slurring of speech.
• Wide-based gait when walking.
• Trouble with writing and eating.
• Slow eye movements.