Ataxia

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Overview

Ataxia is typically defined as the presence of abnormal, uncoordinated movements. This usage describes signs & symptoms without reference to specific diseases. An unsteady, staggering gait is described as an ataxic gait because walking is uncoordinated and appears to be 'not ordered'.

Ataxia is typically defined as the presence of abnormal, uncoordinated movements. This usage describes signs & symptoms without reference to specific diseases. An unsteady, staggering gait is described as an ataxic gait because walking is uncoordinated and appears to be ‘not ordered’. Many motor activities may be described as ataxic if they appear to others, or are perceived by patients, as uncoordinated.


Ataxia can also refer to a group of neurological disorders in which motor behavior appears uncoordinated. Walking, speaking clearly, swallowing, writing, reading, and other activities that require fine motor control may be abnormal in patients with ataxia. Ataxia may result from abnormalities in different parts of the nervous system or different parts of the body, such as ataxic movements due to orthopedic injuries or pain from arthritis or muscle injury.

Symptoms

Ataxia may result from abnormalities in different parts of the nervous system, including the central nervous system (brain and spinal cord) and peripheral nervous system (roots and nerves that connect the central nervous system to muscles, skin, and the outside world). When patients experience abnormal walking or uncoordinated use of their hands or arms, dysfunction of the cerebellum is often responsible. The cerebellum is a rounded structure attached to the brainstem with a central portion (vermis) and two lateral lobes (cerebellar hemispheres). It sits beneath the back of the cerebral hemispheres (occipital cortices). The outer surface of the cerebellum is a continuous layer of nerve cells called the cerebellar cortex. The cortex is a three-layered sheet of neurons that are extensively interconnected and have a highly regular geometric organization. The cerebellar cortex receives information from most parts of the body and from many other regions of the brain. The cerebellum integrates this information and sends signals back to the rest of the brain that enable accurate and well-coordinated movements.


The symptoms of ataxia depend on the type of the condition a person has. In most cases, people with ataxia appear “clumsy.” Symptoms can include:


Decreasing coordination

Trouble walking

Impaired balance with frequent falls

Heart problems

Loss of fine motor skills

Muscle tremors

Slurred speech

Vision problems

Causes

Ataxia may result from abnormalities in different parts of the nervous system, including the central nervous system (brain and spinal cord) and peripheral nervous system (roots and nerves that connect the central nervous system to muscles, skin, and the outside world). When patients experience abnormal walking or uncoordinated use of their hands or arms, dysfunction of the cerebellum is often responsible. The cerebellum is a rounded structure attached to the brainstem with a central portion (vermis) and two lateral lobes (cerebellar hemispheres). It sits beneath the back of the cerebral hemispheres (occipital cortices). The outer surface of the cerebellum is a continuous layer of nerve cells called the cerebellar cortex. The cortex is a three-layered sheet of neurons that are extensively interconnected and have a highly regular geometric organization. The cerebellar cortex receives information from most parts of the body and from many other regions of the brain. The cerebellum integrates this information and sends signals back to the rest of the brain that enable accurate and well-coordinated movements.


Although unsteady gait may result from problems in different parts of the nervous system or of the body, abnormal walking due to cerebellar dysfunction has distinct features that are usually recognizable. Persons with an ataxic gait due to cerebellar dysfunction keep their legs further apart than normal, referred to clinically as a ‘broadened base’. They often stagger and resemble persons who have ingested excessive alcohol. The resemblance of ataxia to inebriation is not a coincidence as alcohol is known to affect the main nerve cells in the cerebellum. Although brief alcohol-induced staggering is usually reversible, repeated exposure to high doses of alcohol may cause degeneration of neurons in the cerebellum and result in persistent ataxia. A main group of cerebellar neurons is unusually susceptible to different forms of injury, including other toxins, prolonged seizures, and lack of oxygen. Cerebellar ataxia differs from gait problems due to abnormalities in other parts of the nervous system, such as the abnormal gait seen in Parkinson’s disease, normal pressure hydrocephalus, or different forms of spasticity in the legs. Cerebellar ataxia is also distinguishable from abnormal walking due to pain and/or muscle or orthopedic abnormalities in the hips, legs, or feet.

Risk factors

Ataxia usually results from damage to the part of the brain that controls muscle coordination (cerebellum) or its connections. Many conditions can cause ataxia, including alcohol misuse, stroke, tumor, brain degeneration, multiple sclerosis, certain medications and genetic disorders.

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Complications

Other complications of ataxia may include:

Dizziness.

Spasticity.

Rigidity.

Tremor.

Pain.

Fatigue.

Low blood pressure with sitting or standing.

Bowel or bladder dysfunction.

Prevention

episodic ataxia can often be controlled with a medication called acetazolamide and by avoiding triggers such as stress, alcohol and caffeine. acquired ataxia can sometimes be treated depending on the specific cause – for example, antibiotic or antiviral medication may help if it's caused by an infection.