Ataxia

• Ataxia is a neurological sign rather than a distinct condition or a group of conditions. It results from dysfunction in brain regions responsible for coordinating movement; most commonly the cerebellum, but also the spinal cord, nerves, and nerve roots.
• Ataxia leads to uncoordinated movements, which can affect balance, speech, and motor control.
• Causes of ataxia vary and may include genetic disorders, brain or spinal cord injuries, infections, toxins, metabolic diseases, and neurological conditions such as multiple sclerosis or stroke.
• Treatment depends on the cause; some types of ataxia are treatable or even curable, while others require symptom management to improve quality of life. 1

Ataxia is not a condition but a neurological sign resulting from dysfunction in the brain regions responsible for coordinating movement; most commonly the cerebellum, but also the spinal cord, nerves, and nerve roots. This dysfunction can lead to symptoms such as loss of muscle coordination, balance issues, and difficulty walking, eating, and speaking. There are various types of ataxia, each with its own underlying cause and treatment options. In this guide by Ada’s medical team, you’ll find more information about ataxia symptoms, causes, and treatments.

Ataxia is a neurological sign, not a condition, that results from dysfunction in the brain regions responsible for coordinating movement. While the most common cause is damage or dysfunction of the cerebellum, other parts of the nervous system such as the spinal cord, nerves, and nerve roots can also be involved. Ataxia affects coordination, balance, and speech, leading to a range of symptoms that vary in severity depending on the underlying cause. 2

Ataxia can be divided into three categories, depending on the cause of the condition. 2 3

1. Acquired ataxia, which is an issue with your coordination, balance and/or speech due to a trauma to the head or conditions that affect the brain such as stroke, multiple sclerosis, or a brain tumor. In some cases, ataxia can also develop due to a vitamin E deficiency or due to the presence of toxins. 
2. Hereditary ataxia, which is ataxia that develops as a result of a faulty gene. These genes are inherited by your parents. The most common form of hereditary ataxia is Friedreich’s ataxia. Other examples are ataxia-telangiectasia, spinocerebellar ataxia and episodic ataxia. 
3.  Idiopathic ataxia, which is ataxia with an unknown cause. This type of ataxia often tends to get worse over time 4

Ataxia symptoms are primarily related to uncoordinated movement of different muscles in the body. This may include: 2 5 6

• Loss of coordination
• Lack of muscle coordination during voluntary movement
• Frequent falls 
• Difficulty walking 
• Poor balance
• Trouble eating and swallowing
• Problems with eye movement and vision 
• Uncontrollable movements of the hands, arms, or jaws, also known as tremor
• Difficulty writing or doing other tasks that require fine movements 
• Reduced reflexes 

Ataxia symptoms can get worse over time, especially without treatment. The exact symptoms you are experiencing may depend on the type of ataxia you’re suffering from. 

Ataxia can lead to a decrease in quality of life and may even decrease your life expectancy. It is important to visit your doctor if you notice any of the signs of ataxia. If your parents or grandparents suffer from ataxia, then it is also a good idea to visit your doctor. Through genetic testing, you can know whether or not you have inherited the faulty gene responsible for the development of the condition.

Ataxia can have acquired or hereditary causes and is usually associated with dysfunction of the cerebellum, but other parts of the nervous system such as the spinal cord, nerves, and nerve roots can also be involved. Acquired causes include conditions affecting the brain, such as multiple sclerosis or stroke, head trauma, vitamin E deficiency, and excessive alcohol consumption. In some cases, hereditary genetic disorders can also lead to ataxia. 2 6

Many cases of ataxia are permanent, and can not be cured. There are however treatment options available in order to increase your quality of life. Most cases of ataxia tend to get worse over time, with a decreased life expectancy for most people that suffer from the condition. Some forms of ataxia which are due to a vitamin deficiency can however be treated and have a better outlook. 2

In order to diagnose ataxia, a healthcare provider will first ask you questions about your medical history and symptoms, followed by a physical examination. If your healthcare provider suspects that you may suffer from ataxia, then there are certain tests to be done in order to confirm the diagnosis and to rule out other conditions which may cause your symptoms. Some possible tests are: 6

• Blood tests to look for vitamin deficiencies or toxins 
• Urine tests to look for certain toxins 
• MRI or CT scan to look at the cerebellum
• A lumbar puncture to test the cerebrospinal fluid
• An EMG to see how well electrical signals are passed through your nerves
• Genetic testing to look for faulty genes that cause ataxia 

Ataxia treatment depends on the underlying cause. In some cases, treating the root cause such as an infection, vitamin deficiency, or autoimmune condition can help resolve or improve ataxia. However, when the cause cannot be directly treated, therapy focuses on managing symptoms and improving quality of life. Symptom management may include: 2 7

• Physiotherapy to improve your balance and movements 
• Occupational therapy to support you in your daily activities
• Speech therapy to help you speak and eat 
• Medication to relieve your symptoms and treat any possible complications such as heart and bladder issues

Ataxia is a neurological sign, not a distinct condition or a group of conditions. It results from dysfunction in the brain regions responsible for coordinating movement—most commonly the cerebellum, but also the spinal cord, nerves, and nerve roots. Ataxia can cause a variety of symptoms, including issues with balance, coordination, movement, and speech, depending on the underlying cause. While some causes of ataxia, such as infections, can be treated and cured, others require long-term management. Various treatment options are available to help improve symptoms and enhance quality of life.

Q: What are the early signs of ataxia? 
A: Early signs of ataxia often include a subtle loss of coordination, which may first be noticed as frequent tripping, clumsiness, or difficulty with fine motor tasks. Other symptoms can include balance issues, difficulty walking, slurred speech, and trouble swallowing or eating. The severity and progression of symptoms depend on the underlying cause.

Q: Who usually gets ataxia? 
A: Ataxia can happen to anyone, although people who have a relative with ataxia, or people with underlying conditions such as multiple sclerosis or stroke are at a higher risk of developing this neurological sign. 

Q: Does ataxia show up on MRI? 
A: An MRI is one of the possible diagnostic tests that your healthcare provider may recommend. This is because an MRI makes it possible to study the cerebellum in order to find the possible ataxia cause.

Q: Can cerebellar ataxia be reversed? 
A: Whether or not cerebellar ataxia can be reversed depends on the type of cerebellar ataxia. Many cases are not curable, although there are some forms of cerebellar ataxia, such as acute cerebellar ataxia caused by a virus, which can be reversed. 

Q: What is the difference between apraxia vs ataxia? 
A: Ataxia affects the parts of the nervous system that coordinate movement for muscle coordination and balance, whereas apraxia affects the part of the brain tthat processes the information and plans movements. This may cause similar symptoms at times since both conditions can make it difficult to do certain tasks. 

Q: What is the life expectancy of a person with ataxia? 
A: The life expectancy for people suffering from ataxia depends on the cause and the severity of the condition.