Ataxia: Symptoms, Causes and Treatment

2022-03-12 00:00:00

Ataxia is described as a lack of muscle control or coordination of voluntary movements such as walking or lifting objects. As a sign of an underlying condition, ataxia can affect range of motion and can cause difficulties in speaking, eye movements, and swallowing.

Persistent ataxia is usually the result of damage to the part of your brain that controls muscle coordination (the cerebellum). Various conditions like alcohol abuse, certain drugs, stroke, tumor, cerebral palsy, brain degeneration, and multiple sclerosis can result in Ataxia. Inherited defective genes can also cause this condition.

Types of Ataxia

There are three main types of ataxia based on the part of the body affected. These are sensory, cerebellar, and vestibular ataxia-

Sensory Ataxia:This type of ataxia is caused by damage to the somatosensory nervous system. Sensory feedback signals such as vision and hearing are impaired, making it difficult to maintain coordination.

Cerebellar Ataxia:Symptoms of ataxia appear when there is damage in the cerebellum (the part of the brain that controls coordination)

Vestibular Ataxia:When the vestibular system, namely the inner ear and cochlea, are affected, symptoms such as dizziness, nausea, and difficulty in walking in a straight line may occur.

Symptoms of Ataxia

Common symptoms are-

• Unclear speech
• Difficulty in standing and walking
• Loss of balance and coordination
• Difficulty in chewing and swallowing food
• Decreased fine motor skills
• Unusual eye movements
• Heart disorders
• Lung infections
• Tremors

In Ataxia, a particular part of the nervous system is damaged or becomes dysfunctional. The most common form, called cerebellar ataxia, is found in the cerebellum. Sensory ataxia, which affects the spine and peripheral nervous system, and vestibular ataxia, which affects the inner ear and auditory canals.

Can Ataxia be prevented?

There is no cure for ataxia but the symptoms can be reduced or managed with proper treatment. Ataxia is largely unpreventable, if only because there are so many possible causes and it can occur at any age. However, adopting a healthy lifestyle can reduce the risk of certain conditions associated with ataxia, including stroke and cancer, which in turn reduces the risk of other medical conditions.

Causes of Ataxia

Damage, degeneration, or loss of nerve cells in the part of the brain that controls muscle coordination (the cerebellum) causes ataxia. Your cerebellum is made up of two folded pieces of tissue located at the base of your brain near your brainstem. This area of ​​the brain helps with balance, eye movements, swallowing, and speech.

Diseases that damage the spinal cord and the peripheral nerves that connect the cerebellum to the muscles can also cause ataxia. Causes of ataxia are-

Head injury-Damage to the brain or spinal cord from a blow to the head, which can occur in a car accident, can cause sudden, and acute cerebellar ataxia.

Stroke- Obstruction or bleeding in the brain can cause ataxia. When blood flow is cut off or severely reduced to parts of your brain, brain tissue is deprived of oxygen and nutrients, and as a result the brain cells die.

Cerebral palsy- It is a general term for a group of disorders caused by damage to a child's brain during early development, before, during or soon after birth, that affects a child's ability to coordinate body movements.

Autoimmune diseases- Multiple sclerosis, sarcoidosis, celiac disease, and other autoimmune diseases can cause ataxia.

Infection- Ataxia can be an uncommon complication of chickenpox and other viral infections such as HIV and Lyme disease. This can occur in the healing stage of the infection and last for several days or weeks. This type of Ataxia usually resolves over time.

Paraneoplastic syndromes- This is a rare, degenerative disease caused by your immune system's response to a malignant tumor (neoplasm), most commonly lung, ovarian, breast or lymph cancer. Ataxia can occur months or years before the cancer is diagnosed.

Abnormalities in the brain- An infected area (abscess) in the brain can cause ataxia. Cancerous (malignant) or noncancerous (benign) growth in the brain can damage the cerebellum.

Toxic reaction- Ataxia is a possible side effect of some drugs, especially barbiturates such as phenobarbital; sedatives such as benzodiazepines; antiepileptics such as phenytoin; and some types of chemotherapy. Vitamin B-6 toxicity can also cause ataxia. It is important to identify these causes as the effects are often reversible.

In addition, some of the medications you are taking can cause age-related problems, so you may need to reduce your dose or stop taking medications.

Alcohol and drug poisoning-Heavy metal poisoning such as lead or mercury; and solvent poisoning, such as paint thinner, can also cause ataxia.

Deficiency of vitamin E, vitamin B-12, or thiamine- Deficiency of these nutrients due to inability to consume enough of these vitamins, alcohol abuse, or other causes can lead to ataxia.

Thyroid- Hypothyroidism and hypoparathyroidism can cause ataxia.

Covid 19 infection- This infection can cause ataxia but that, usually happens in very severe cases.

Treatment for Ataxia

• Treatment for ataxia depends on the cause. If ataxia is a symptom of another disease, the underlying disease needs to be treated. Treating the underlying disease or disease process can help relieve or reduce symptoms. For example, you may be prescribed physical therapy after a stroke, you may be given help for multiple sclerosis, or you may be asked to take vitamin supplements for vitamin deficiencies. If you have celiac disease, you will be trained to change your diet to eliminate gluten.
• Sometimes you need to see a specialist who will treat the condition causing the symptoms.
• If the ataxia is part of a group of degenerative diseases, your treatment options may include, but are not limited to:

Medications:Riluzole, varenicline, and amantadine are drugs that have shown promising results in improving gait and tremors.

Physical Therapy:Physical therapy that works on balance, gait or movement control can help improve the quality of life for people with ataxia.

When to see a doctor?

If you experience symptoms of ataxia for no apparent reason, it is important to talk to your doctor. They can help diagnose what's going on and start any further treatment that may be needed.

It is best not to ignore symptoms such as difficulty in-

• Coordination or balance
• Walking
• Talking or swallowing

Sudden changes in these functions could potentially indicate emergency medical treatment, such as a stroke. If you suspect someone is having a stroke or other emergency medical condition, call your local emergency services immediately.