Often caused by an underlying condition, this loss of muscle control and coordination can impact movement, speech and swallowing.
Ataxia describes poor muscle control that causes clumsy movements. It can affect walking and balance, hand coordination, speech and swallowing, and eye movements.
Ataxia usually results from damage to the part of the brain called the cerebellum or its connections. The cerebellum controls muscle coordination. Many conditions can cause ataxia, including genetic conditions, stroke, tumors, multiple sclerosis, degenerative diseases and alcohol misuse. Certain medicines also can cause ataxia.
Treatment for ataxia depends on the cause. Devices such as walkers and canes might help maintain independence. These also are called adaptive devices. Physical therapy, occupational therapy, speech therapy and regular exercise also might help.
Ataxia symptoms can develop over time or start suddenly. Ataxia can be a symptom of several nervous system conditions. Symptoms may include:
If you don't already have a condition that causes ataxia, such as multiple sclerosis, see your healthcare professional as soon as possible if you:
Ataxia is caused by damage to the part of the brain called the cerebellum or its connections. The cerebellum is located at the base of the brain and connects to the brainstem. The cerebellum helps control balance, eye movements, swallowing and speech.
There are three major groups of ataxia causes: acquired, degenerative and hereditary.
Some types of ataxia and some conditions that cause ataxia are passed down in families. These conditions also are called hereditary. If you have one of these conditions, you may have been born with a genetic change that causes the body to make irregular proteins.
The irregular proteins affect the function of nerve cells, primarily in the cerebellum and spinal cord. They cause the nerve cells to break down and die, known as degeneration. As the disease progresses, coordination problems worsen.
People with a genetic ataxia may have inherited a dominant gene from one parent, known as an autosomal dominant inheritance pattern. Or they may have inherited a recessive gene from both parents, known as an autosomal recessive inheritance pattern. In a recessive condition, the parents are not affected but siblings may be affected.
Different gene changes cause different types of ataxia. Most types get worse over time. Each type causes poor coordination but also has other specific symptoms.
Episodic ataxia (EA). There are eight recognized types of episodic ataxia. The types EA1 and EA2 are the most common. EA1 involves brief bouts of ataxia that may last seconds or minutes. The bouts are triggered by stress, sudden movement or being startled. They're often associated with muscle twitching.
EA2 involves longer bouts of ataxia, usually lasting from 30 minutes to six hours. These bouts also are triggered by stress. Dizziness and muscle weakness may occur. People with EA2 may feel very tired. Sometimes symptoms resolve later in life. Episodic ataxia doesn't shorten life span, and symptoms may respond to medicine.
Friedreich 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. Symptoms typically appear well before age 25. A brain scan usually doesn't show changes to the cerebellum with this type of ataxia.
The first symptom of Friedreich ataxia often is trouble walking. The condition typically goes on to affect the arms and trunk. This type of ataxia can cause changes to the feet, such as high arches. It also can cause a curve of the spine, known as scoliosis.
Other symptoms that might develop include slurred speech, fatigue, irregular eye movements and hearing loss. Friedreich ataxia also may lead to heart enlargement, known as cardiomyopathy. Heart failure and diabetes also can occur. Early treatment of heart conditions can improve quality of life and survival.
Ataxia-telangiectasia. This rare childhood disease causes degeneration in the brain and 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 a child's eyes or on the ears and cheeks. Delayed motor skill development, poor balance and slurred speech are often the first symptoms. 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. It's located on one of the nonsex chromosomes, called autosomes. Only one changed gene is needed to be affected by this type of condition. A person with an autosomal dominant condition — in this example, the father — has a 50% chance of having an affected child with one changed gene. The person has a 50% chance of having an unaffected child.
There are several risk factors for ataxia. People who have a family history of ataxia are at a higher risk of having ataxia themselves.
Other risk factors include:
When diagnosing ataxia, your healthcare professional looks for a treatable cause. You'll likely have physical and neurological exams. Your healthcare professional checks your vision, balance, coordination and reflexes. You also might need:
Ataxia treatment depends on the cause. If ataxia is caused by a condition such as vitamin deficiency or celiac disease, treating the condition may help improve symptoms. If ataxia results from chickenpox or other viral infections, it is likely to resolve on its own.
People with Friedreich ataxia can be treated with an oral medicine called omaveloxolone (Skyclarys). The U.S. Food and Drug Association approved the medicine for adults and teenagers 16 and older. In clinical trials, taking the medicine improved symptoms. People who take this medicine need regular blood tests because omaveloxolone can affect liver enzyme and cholesterol levels. Potential side effects of omaveloxolone include headache, nausea, stomach pain, fatigue, diarrhea, and muscle and joint pain.
Symptoms such as stiffness, tremor and dizziness might improve with other medicines. Your healthcare professional also might recommend adaptive devices or therapies.
Ataxia caused by conditions such as multiple sclerosis or cerebral palsy might not be treatable. But adaptive devices may help. They include:
You might benefit from certain therapies, including:
Some studies have found that aerobic and strength exercises may be beneficial for some people with ataxia.
Living with ataxia or having a child with the condition can be challenging. For some people, having ataxia may lead to depression and anxiety. Talking with a counselor or therapist might help. Joining a support group for ataxia or for a condition causing ataxia may provide information and encouragement.
Support group members often know about the latest treatments and tend to share their own experiences. Your healthcare professional might be able to recommend a group in your area.
You're likely to start by seeing your healthcare professional. 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.
For ataxia, basic questions to ask include:
Don't hesitate to ask other questions.
Your healthcare professional is likely to ask you questions, such as:
Don't drink alcohol or take legal or illegal drugs that may be sold on the street, also called recreational drugs, which can make your ataxia worse.