Often caused by an underlying condition, ataxia affects muscle control and coordination and impacts movement, speech and swallowing.
Ataxia describes poor muscle control that causes clumsy voluntary movements. It may cause difficulty with walking and balance, hand coordination, speech and swallowing, and eye movements.
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.
Treatment for ataxia depends on the cause. Adaptive devices, such as walkers or canes, might help maintain independence. Physical therapy, occupational therapy, speech therapy and regular aerobic exercise also might help.
Persistent ataxia usually results from damage to the part of your brain that controls muscle coordination (cerebellum).
Ataxia can develop over time or come on suddenly. Ataxia is a sign of several neurological disorders and can cause:
If you don't have a condition that causes ataxia, such as multiple sclerosis, see your doctor as soon as possible if you:
Damage to the part of your brain that controls muscle coordination (cerebellum) or its connections can cause ataxia. The cerebellum, located at the base of the brain, connects to the brainstem. The cerebellum helps control balance, eye movements, swallowing and speech. There are three major groups of ataxia causes: acquired, degenerative disease and hereditary causes.
Some types of ataxia and some conditions that cause ataxia are hereditary. If you have one of these conditions, you may have been born with a mutation in a certain gene that makes irregular proteins.
The abnormal proteins hamper the function of nerve cells, primarily in the cerebellum and spinal cord, and cause them to degenerate. As the disease progresses, coordination problems worsen.
You can inherit a genetic ataxia from either a dominant gene from one parent (autosomal dominant disorder) or a recessive gene from both parents (autosomal recessive disorder). In a recessive disorder, the parents are unaffected, and there may be affected siblings.
Different gene mutations cause different types of ataxia, most of which are progressive. Each type causes poor coordination, but each has specific signs and symptoms.
Friedreich's ataxia. This is the most common hereditary ataxia. It involves damage to the cerebellum, spinal cord and peripheral nerves. Peripheral nerves carry signals from the arms and legs to the brain and spinal cord. In most cases, signs and symptoms appear well before age 25. The cerebellum usually appears normal on a brain scan.
The first indication generally is difficulty walking. The condition typically progresses to the arms and trunk. There are often deformities of the feet, such as high arches, and curvature of the spine (scoliosis).
Other signs and symptoms that might develop include slurred speech (dysarthria); fatigue; involuntary eye movements (nystagmus); hearing loss; heart enlargement (cardiomyopathy) and heart failure, and diabetes. Early treatment of heart problems can improve quality of life and survival.
Ataxia-telangiectasia. This rare, progressive childhood disease causes degeneration in the brain and the immune system. This increases the risk of other diseases, including infections and tumors.
Telangiectasia is the formation of tiny red "spider" veins that might appear in the corners of your child's eyes or on the ears and cheeks. Delayed motor skill development, poor balance and slurred speech are often the first signs. Frequent sinus and respiratory infections are common.
Children with ataxia-telangiectasia are at high risk of developing cancer, particularly leukemia or lymphoma.
In an autosomal dominant disorder, the changed gene is a dominant gene on one of the nonsex chromosomes, also known as autosomes. A person needs only one irregular gene to be affected by this type of disorder. A person with the disorder — in this case, the father — has a 50% chance of having an affected child, male or female.
If you have ataxia, your doctor will look for a treatable cause. Besides conducting a physical exam and a neurological exam, including checking your vision, balance, coordination and reflexes, your doctor might request tests, including:
There is no specific treatment for ataxia. In some cases, treating the underlying cause may help improve the ataxia. In other cases, such as ataxia that results from chickenpox or other viral infections, it is likely to resolve on its own. Your doctor might recommend adaptive devices or therapies to help with your ataxia. Other symptoms such as stiffness, tremor and dizziness might improve with treatments.
Ataxia caused by conditions such as multiple sclerosis or cerebral palsy might not be treatable. In that case, your doctor may be able to recommend adaptive devices. They include:
You might benefit from certain therapies, including:
Some studies have indicated that aerobic exercise may be beneficial for some people with idiopathic ataxic syndromes.
The challenges of living with ataxia or having a child with the condition may feel isolating or lead to depression and anxiety. Talking to a counselor or therapist might help. Engaging with a support group, either for ataxia or for the underlying condition, may also provide information and encouragement.
Support group members often know about the latest treatments and tend to share their own experiences. If you are interested, your health care provider might be able to recommend a group in your area.
You're likely to start by seeing your health care provider. In some cases, you may be referred to a neurologist.
Here's some information to help you get ready for your appointment.
When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test. Make a list of:
Take a family member or friend along, if possible, to help you remember the information you get.
Your doctor is likely to ask you questions, such as:
For ataxia, basic questions to ask your doctor include:
Don't hesitate to ask other questions.
Don't drink alcohol or take recreational drugs, which can make your ataxia worse.