Purpose and Summary:
The article aims to introduce the background and common causes of ataxia and offers a general approach to assessing and managing patients with this condition. Clinicians are advised to be familiar with the spectrum of diseases that can present with ataxia and to design proper diagnostic tests based on a detailed history and neurologic examination.Recent Findings:
- Ataxia is a manifestation of various disease processes and is rarely pure in acquired disorders; associated symptoms almost always suggest an underlying cause.
- While hereditary degenerative ataxias are expanding, attention should be given to treatable and reversible etiologies, especially those that are potentially life-threatening.
- Emerging genetic tests are increasingly available for hereditary ataxia but cannot replace conventional diagnostic procedures in most cases.
Introduction:
Ataxia is defined as impaired coordination of voluntary muscle movement and is not a disease itself but a symptom. It can have various onsets—insidious, acute, or subacute—and is usually caused by cerebellar dysfunction or impaired vestibular or proprioceptive input to the cerebellum.Symptoms and Signs:
- Limb Ataxia: Usually results from lesions in the cerebellar hemisphere.
- Truncal Ataxia: May result from midline cerebellar lesions.
- Gait Ataxia: Results from incoordination of the lower extremities.
- Sensory Ataxia: Mainly reflected by gait disturbance and a positive Romberg sign.
- Dysdiadochokinesia/Dysrhythmokinesis: Tested by rapidly alternating hand movements.
- Intention Tremor: Results from instability of the proximal portion of the limb.
- Dysmetria: The patient misses the targeted object either due to overshoot or undershoot.