Ataxia: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
No edit summary
 
(58 intermediate revisions by 7 users not shown)
Line 1: Line 1:
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
__NOTOC__
__NOTOC__
{{Infobox_Disease |
{{Infobox_Disease |
Line 6: Line 5:
ICD9 = 781.3
ICD9 = 781.3
}}
}}
{{SI}}
{{Ataxia}}
{{CMG}}; '''Associate Editor in Chief:''' {{MUT}} {{RT}}


'''''Synonyms and keywords:''''' unsteady gait, ataxy, staggering gait
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''


==Overview==
{{CMG}}; '''Associate Editor in Chief:''' {{MUT}}; {{RT}} {{APG}}
'''Ataxia''' (from Greek ''α-'' [used as a negative prefix] + ''-τάξις'' [order], meaning "lack of order") is a [[neurology|neurological]] sign and symptom consisting of gross incoordination of [[muscle]] movements. <ref>{{Dorlands|a_69|12166205}}</ref> Ataxia is an aspecific clinical manifestation implying dysfunction of parts of the [[nervous system]] that coordinate movement, such as the [[cerebellum]]. Several possible causes exist for these patterns of neurological dysfunction. The term "dystaxia" is rarely used as a synonym.


The International Ataxia Awareness Day is observed on September 25th each year.<ref name="titleNational Ataxia Foundation - International Ataxia Awareness Day">{{cite web |url=http://www.ataxia.org/events/international-ataxia-awareness-day.aspx |title=National Ataxia Foundation - International Ataxia Awareness Day |accessdate=2008-03-25 |format= |work=}}</ref>
'''''Synonyms and keywords:''''' Unsteady gait; ataxy; staggering gait; impaired coordination; lack of coordination; incoordination; incoordination of muscle movement


==Classification of ataxia==
==[[Ataxia overview|Overview]]==
===Cerebellar ataxia===
The term '''cerebellar ataxia''' is employed to indicate ataxia due to dysfunction of the cerebellum. This causes a variety of elementary neurological deficits, such as antagonist [[hypotonia]], [[asynergy]], [[dysmetria]], dyschronometria, and [[dysdiadochokinesia]]. How and where these abnormalities manifest depend on which cerebellar structures are lesioned, and whether the lesion is bilateral or unilateral.
'''Vestibulo-cerebellar dysfunction''' presents with [[postural instability]], in which the person tends to separate the feet on standing to gain a wider base, and avoid oscillations (especially posterior-anterior ones); instability is therefore worsened when standing with the feet together (irrespective of whether the eyes are open or closed: this is a negative [[Romberg's test]]).
'''Spino-cerebellar dysfunction''' presents with a wide-based "drunken sailor" gait, characterised by uncertain start and stop, lateral deviations, and unequal steps.
'''Cerebro-cerebellar dysfunction''' presents with disturbances in carrying out voluntary movements, including [[intention tremor]] (coarse trembling, accentuated over the execution of voluntary movements, possibly involving the head and eyes as well as the limbs and torso), peculiar writing abnormalities (large, unequal letters, irregular underlining), and a peculiar pattern of [[dysarthria]] (slurred speech, sometimes characterised by explosive variations in voice intensity despite a regular rhythm).


===Sensory ataxia===
==[[Ataxia classification scheme|Classification]]==
The term '''sensory ataxia''' is employed to indicate ataxia due to loss of [[proprioception]] (sensitivity to joint and body part position), which generally depends on dysfunction of the [[dorsal columns]] of the [[spinal cord]], since they carry proprioceptive information up to the brain; in some cases, the cause may instead be dysfunction of the various brain parts that receive that information, including the cerebellum, [[thalamus]], and [[parietal lobe|parietal lobes]]. Sensory ataxia presents
with an unsteady "stomping" gait with heavy [[heel]] strikes, as well as postural instability that is characteristically worsened when the lack of proprioceptive input cannot be compensated by [[sight|visual input]], such as in poorly lit environments. Doctors can evidence this during [[physical examination]] by having the patient stand with his / her feet together and [[eye|eyes]] shut, which will cause the patient's instability to markedly worsen, producing wide oscillations and possibly a fall (this is called a positive [[Romberg's test]]). Worsening of the finger-pointing test with the eyes closed is another feature of sensory ataxia. Also, when the patient is standing with arms and hands extended toward the examiner, if the eyes are closed, the patient's finger will tend to "fall down" and be restored to the horizontal extended position by sudden extensor contractions ("ataxic hand").


===Vestibular ataxia===
==[[Ataxia pathophysiology|Pathophysiology]]==
The term '''vestibular ataxia''' is employed to indicate ataxia due to dysfunction of the [[vestibular system]], which in acute and unilateral cases is associated with prominent [[vertigo (medical)|vertigo]], [[nausea]] and [[vomiting]]. In slow-onset, chronic bilateral cases of vestibular dysfunction, these characteristic manifestations may be absent, and dysequilibrium may be the sole presentation.


==Causes==
==[[Ataxia causes|Causes]]==
===Common Causes===


===Causes by Organ System===
==[[Ataxia differential diagnosis|Differentiating Ataxia from other Diseases]]==


{|style="width:80%; height:100px" border="1"
==[[Ataxia epidemiology and demographics|Epidemiology and Demographics]]==
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Arteriosclerosis]], Circulation disorders in area of [[brain stem]], [[Morgagni's Syndrome]]
|-
|-bgcolor="LightSteelBlue"
| '''Chemical / poisoning'''
|bgcolor="Beige"| [[2,4,6-Trichlorophenol]], [[Acrylamide]], [[Aftershave]], [[Amitraz]], [[Aniline]], [[Antifreeze]], [[Apple seed poisoning]], [[Arizona Bark Scorpion poisoning]], [[Benzene]], [[Blue-ringed octopus poisoning]], [[Buckeye poisoning]], [[Carbon monoxide poisoning]], [[Death Camas poisoning]], [[English Ivy poisoning]], [[Gasoline]], [[Lantana poisoning]], [[Lead]], [[Mayapple poisoning]], [[Mercury]], [[Mescal poisoning]], [[Minamata disease]], [[Mistletoe poisoning]], [[Thallium poisoning]], [[Tolterodine toxicity]], [[Toxic mushrooms -- Anticholinergic]], [[Toxic mushrooms -- Monomethylhydrazine]], [[Toxic mushrooms -- Psychedelic]], [[Varnish makers' and painters' Naptha]], [[Xylene]]
|-
|-bgcolor="LightSteelBlue"
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Amiodarone]], [[Barbituates]], [[Benzodiazepines]], [[Ethosuximide]], [[Gabapentin]], [[Lamotrigine]],  [[Levetiracetam]], [[Metronidazole]], [[Morphine]], [[Oxcarbazepine]], [[Primidone]]
|-
|-bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Endocrine'''
|bgcolor="Beige"|
[[Diabetic neuropathy]],
[[Hypothyroidism]],


|-
==[[Ataxia risk factors|Risk Factors]]==
|-bgcolor="LightSteelBlue"
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
|bgcolor="Beige"|
[[Cirrhosis]],
[[Malabsorption]],


|-
==[[Ataxia natural history|Natural History, Complications and Prognosis]]==
|-bgcolor="LightSteelBlue"
| '''Genetic'''
|bgcolor="Beige"|
[[Familial periodic ataxia]],
[[Fredreich's Ataxia]],
[[Hartnup Syndrome]],
[[Hereditary spastic paraparesis]],
Inherited neuropathies,


|-
==Diagnosis==
|-bgcolor="LightSteelBlue"
[[Ataxia history and symptoms|History and Symptoms]] | [[Ataxia physical examination|Physical Examination]] | [[Ataxia laboratory tests|Laboratory Findings]] | [[Ataxia x ray|X Ray]] | [[Ataxia CT|CT]] | [[Ataxia MRI|MRI]] | [[Ataxia other imaging findings|Other Imaging Findings]] | [[Ataxia other diagnostic studies|Other Diagnostic Studies]]
| '''Hematologic'''
|bgcolor="Beige"|  
[[Acanthocytosis]],
[[Ataxia-teleangiectasia]],


|-
<ref name="pmid30786918">{{cite journal |vauthors=de Silva R, Greenfield J, Cook A, Bonney H, Vallortigara J, Hunt B, Giunti P |title=Guidelines on the diagnosis and management of the progressive ataxias |journal=Orphanet J Rare Dis |volume=14 |issue=1 |pages=51 |date=February 2019 |pmid=30786918 |pmc=6381619 |doi=10.1186/s13023-019-1013-9 |url=}}</ref>
|-bgcolor="LightSteelBlue"
| '''Iatrogenic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Infectious Disease'''
|bgcolor="Beige"|  
[[Chickenpox]],
[[HIV infection]],
[[Smallpox]],


|-
==Treatment==
|-bgcolor="LightSteelBlue"
The ataxia that occurs in children can often can go away in a few months without any treatment. In cases where an underlying cause is identified, the cause will be treated.
| '''Musculoskeletal / Ortho'''
|bgcolor="Beige"|
[[Myopathy]],


|-
In some cases, you may have continuing and disabling symptoms. Treatment includes:
|-bgcolor="LightSteelBlue"
| '''Neurologic'''
|bgcolor="Beige"| [[Acute Disseminated Encephalomyelitis]], [[Alexander Syndrome]], [[Alpers Syndrome]], [[Arachnoid Cysts]], [[Arnold-Chiari Malformation]], [[ARTS syndrome]], [[Ataxia deafness reardon type]], [[Ataxia tapetoretinal degeneration]], [[Ataxia telangiectasia / Louis-Bar syndrome]], [[Ataxia-oculomotor apraxia syndrome]], [[Basal ganglia calcification]], [[Basilar artery migraine]], [[Vertebro-basilar artery ischemia]], [[Brain abscess]], [[Brain cancer]], [[Brain cyst]], [[Brain injury]], [[Brainstem or cortical lesions]], [[Central nervous system lymphoma, primary]], [[Cerebellar abscess]], [[Cerebellar ataxia]], [[Cerebellar cortex atrophy]], [[Cerebellar degeneration]], [[Cerebellar haemorrhage]], [[Cerebellar heredoataxia]], [[Cerebellar hypoplasia]], [[Cerebellar infarct]], [[Cerebellar mass]], [[Cerebral Amyloid Angiopathy, Familial]], [[Cerebral hemorrhage]], [[Cerebral infarction]], [[Cerebral palsy]], [[Cerebrorenodigital syndrome]], [[Cerebrovascular accident]], [[Ceroid lipofuscinosis]], [[Cervical myelopathy]], [[Chorea familial benign]], [[Chronic progressive traumatic encephalopathy]], [[Cockayne syndrome]], [[Combarros Calleja Leno syndrome]], [[Corneal cerebellar syndrome]], [[Creutzfeldt-Jakob disease]], [[Cutler-Bass-Romshe syndrome]], [[Dandy-Walker Syndrome]], [[Dementia pugilis]], [[Demyelinating disorder]], [[DeSanctis-Cacchione syndrome]], [[Dinno-Shearer-Weisskopf syndrome]], [[Dravet syndrome]], [[Dykes-Markes-Harper syndrome]], [[Dysequilibrium syndrome]], [[Encephalitis]], [[Encephalocele frontal]], [[Epiphyseal tumor]], [[Episodic ataxia]], [[Erythrokeratodermia with ataxia]], [[Feline spongiform encephalopathy]], [[Fisher's Syndrome]], [[Friedreich's ataxia]], [[Frontal lobe lesion]], [[GALOP Syndrome]] (gait disorder, autoantibodies, late age onset, polyneuropathy), [[Glioma]], [[Granulomatous Angiitis of the central nervous system]], [[Guillain-Barré syndrome]], [[Hallervorden-Spatz disease]], [[Heidenhain syndrome]], [[Hepatocerebral degeneration]], [[Hydrocephalus]], [[Infantile polymyoclonus]], [[Inherited neuropathies]], [[Joubert syndrome]], [[Juvenile pilocytic astrocytoma]], [[Kearns-Sayre Syndrome]], [[Kuru]], [[Lhermitte-McAlpine syndrome]], [[Machado-Joseph Disease]], [[Macrogyria, pseudobulbar palsy and mental retardation]], [[Mann Syndrome]], [[Marinesco-Sjogren-like syndrome]] (MSLS), [[Marinescu-Garland Syndrome]], [[Medulloblastoma]], [[Meinecke syndrome]], [[Meningoencephalocele]], [[Mental retardation progressive spasticity, X-linked]], [[Mental retardation, X-linked, with cerebellar hypoplasia and distinctive facial appearance]], [[Metachromatic Leukodystrophy]], [[Miller Fisher Syndrome]], [[Mitochondrial encephalomyopathy]], [[Mononeuropathy/radiculopathy affecting the lower extremities]], [[Multiple sclerosis]], [[Myelopathy]], [[Myoclonus]], [[Neuronal intranuclear hyaline inclusion disease]], [[Normal pressure hydrocephalus]], [[Olivopontocerebellar atrophy]], [[Opsoclonus myoclonus syndrome]], [[Parietal lobe lesion]], [[Parkinson's disease]], [[Partington X-linked mental retardation syndrome]], [[Pelizaeus-Merzbacher disease]], [[Peripheral neuropathy]], [[Polyneuritis]], [[Polyneuropathy]], [[Post-infective polyradiculopathy]], [[Posterior column ataxia with retinitis pigmentosa]], [[Posterior fossa tumor]], [[Progressive Multifocal Leukoencephalopathy]], [[Reardon-Wilson-Cavanagh syndrome]], [[Rett syndrome]], [[Rhombencephalosynapsis]], [[Roussy-Levy syndrome]], [[Schroer-Hammer-Mauldin syndrome]], [[Segawa syndrome, autosomal recessive]], [[Shy-Drager syndrome]], [[Spastic paraplegia]], [[Spinal cord compression (and pressure on dorsal nerve roots)]], [[Spinal cord tumor]], [[Spinocerebellar ataxia]], [[Spinocerebellar degenerescence, book type]], [[Stroke]], [[Susac syndrome]], [[Tabes dorsalis]], [[Telencephalic leukoencephalopathy]], [[Thalamic syndrome]], [[Thoracic dysplasia -- hydrocephalus syndrome]], [[Tranebjaerg-Svejgaard syndrome]], [[Transient ischemic attack (TIA)]], [[Transverse myelitis]], [[Vascular dementia]], [[Vertebral Artery Dissection]], [[Vertebrobasilar dolichoectasia]], [[Vertigo, benign paroxysmal]], [[Westphal's Disease]], [[Wilson's Disease]]
|-
|-bgcolor="LightSteelBlue"
| '''Nutritional / Metabolic'''
|bgcolor="Beige"|
[[Alcohol]],
Alpha-beta lipoproteinemia,
[[GM2-gangliosidoses]],
[[Thiamine deficiency]],
[[Wilson's Disease]],


|-
* Corticosteroids
|-bgcolor="LightSteelBlue"
* IV immune globulin
| '''Obstetric/Gynecologic'''
* Plasma exchange therapy
|bgcolor="Beige"| No underlying causes
* Medications to improve muscle coordination
|-
|-bgcolor="LightSteelBlue"
| '''Oncologic'''
|bgcolor="Beige"|
Epiphyseal tumor,
[[Paraneoplastic syndrome]],


|-
Occupational or physical therapy may also be needed. Changes to diet and nutritional supplements may also help.
|-bgcolor="LightSteelBlue"
| '''Opthalmologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Overdose / Toxicity'''
|bgcolor="Beige"|
[[Intoxication]],


|-
|-bgcolor="LightSteelBlue"
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Renal / Electrolyte'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Rheum / Immune / Allergy'''
|bgcolor="Beige"|
[[Fisher's Syndrome]],


|-
|-bgcolor="LightSteelBlue"
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Trauma'''
|bgcolor="Beige"|
[[Brainstem]] or cortical lesions,
[[Frontal lobe]]lesion,
[[Mann Syndrome]],
[[Parietal lobe]]lesion,


|-
|-bgcolor="LightSteelBlue"
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
|-
|-bgcolor="LightSteelBlue"
| '''Miscellaneous'''
|bgcolor="Beige"|Mitochondrial cytopathy,


|-
|}
===Causes by Alphabetical Order===
{{MultiCol}}
*[[2,4,6-Trichlorophenol]]
*[[Abetalipoproteinemia]]
*[[Acanthocytosis]]
*[[Aceruloplasminemia]]
*[[Acoustic neurinoma]]
*[[Acrylamide]]
*[[Acute altitude sickness]]
*[[Acute Disseminated Encephalomyelitis]]
*[[Adult-onset adreno leukodystrophy]]
*[[Aftershave]]
*[[Alcohol intoxication]]
*[[Alexander Syndrome]]
*[[Alpers Syndrome]]
*[[Alpha-ketoglutarate dehydrogenase deficiency]]
*[[Aminoaciduria]]
*[[Amiodarone]]
*[[Amitraz]]
*[[Amyloidosis, oculoleptomeningeal]]
*[[X-linked sideroblastic anaemia]]
*[[Angleman syndrome]]
*[[Aniline]]
*[[Antifreeze]]
*[[Apple seed poisoning]]
*[[Arachnoid Cysts]]
*[[Argininosuccinase lyase deficiency - late onset]]
*[[Arginosuccinate synthetase deficiency]]
*[[Arizona Bark Scorpion poisoning]]
*[[Arnold-Chiari Malformation]]
*[[Arteriosclerosis]]
*[[ARTS syndrome]]
*[[Ataxia deafness reardon type]]
*[[Ataxia tapetoretinal degeneration]]
*[[Ataxia telangiectasia / Louis-Bar syndrome]]
*[[Ataxia with Vitamin E Deficiency]]
*[[Ataxia-oculomotor apraxia syndrome]]
*[[Bangstad syndrome]]
*[[Barbituates]]
*[[Basal ganglia calcification]]
*[[Basilar artery migraine]]
*[[Basilar impression / vertebral-basilar artery ischemia]]
*[[Bassen-Kornzweig syndrome]]
*[[Benign Paroxysmal Positional Vertigo]]
*[[Benzene]]
*[[Benzodiazepines]]
*[[Bhaskar-Jagannathan syndrome]]
*[[Biotinidase deficiency]]
*[[Blue-ringed octopus poisoning]]
*[[Bonnemann-Meinecke-Reich syndrome]]
*[[Brain abscess]]
*[[Brain cancer]]
*[[Brain cyst]]
*[[Brain injury]]
*[[Brainstem or cortical lesions]]
*[[Bronchogenic carcinoma]]
*[[Buckeye poisoning]]
*[[Carbon monoxide poisoning]]
*[[Celiac disease]]
*[[Central nervous system lymphoma, primary]]
*[[Cerebellar abscess]]
*[[Cerebellar ataxia]]
*[[Cerebellar cortex atrophy]]
*[[Cerebellar degeneration]]
*[[Cerebellar haemorrhage]]
*[[Cerebellar heredoataxia]]
*[[Cerebellar hypoplasia]]
*[[Cerebellar infarct]]
*[[Cerebellar mass]]
*[[Cerebral Amyloid Angiopathy, Familial]]
*[[Cerebral hemorrhage]]
*[[Cerebral infarction]]
*[[Cerebral palsy]]
*[[Cerebrorenodigital syndrome]]
{{ColBreak}}
*[[Cerebrovascular accident]]
*[[Ceroid lipofuscinosis]]
*[[Ceruloplasmin deficiency]]
*[[Cervical myelopathy]]
*[[Chickenpox]]
*[[Chitayat-Moore-Del Bigio syndrome]]
*[[Cholestanol storage disease]]
*[[Chorea familial benign]]
*[[Chronic progressive traumatic encephalopathy]]
*[[Cirrhosis]]
*[[Cockayne syndrome]]
*[[Coenzyme Q 10 (CoQ10), deficiency]]
*[[Combarros Calleja Leno syndrome]]
*[[Complex 2 mitochondrial respiratory chain deficiency]]
*[[Congenital Disorders of Glycosylation]]
*[[Corneal cerebellar syndrome]]
*[[Creutzfeldt-Jakob disease]]
*[[Cutler-Bass-Romshe syndrome]]
*[[Cystinuria -- lysinuria]]
*[[Dandy-Walker Syndrome]]
*[[DeSanctis-Cacchione syndrome]]
*[[Death Camas poisoning]]
*[[Dementia pugilis]]
*[[Demyelinating disorder]]
*[[Diabetic neuropathy]]
*[[Dinno-Shearer-Weisskopf syndrome]]
*[[Diphtheria]]
*[[Dravet syndrome]]
*[[Dykes-Markes-Harper syndrome]]
*[[Dysequilibrium syndrome]]
*[[Encephalitis]]
*[[Encephalocele frontal]]
*[[Encephalopathy due to sulphite oxidase deficiency]]
*[[English Ivy poisoning]]
*[[Epiphyseal tumor]]
*[[Episodic ataxia]]
*[[Erythrokeratodermia with ataxi]]
*[[Ethosuximide]]
*[[Fabry's Disease]]
*[[Familial isolated deficiency of vitamin E]]
*[[Familial periodic ataxia]]
*[[Feline spongiform encephalopathy]]
*[[Fisher's Syndrome]]
*[[Friedreich's ataxia]]
*[[Frontal lobe lesion]]
*[[Functioning pancreatic endocrine tumor]]
*[[Furukawa-Takagi-Nakao syndrome]]
*[[Gabapentin]]
*[[GALOP Syndrome (gait disorder, autoantibodies, late age onset, polyneuropathy)]]
*[[Gangliosidosis GM1 type 3 - gait ataxia]]
*[[Gasoline]]
*[[Gaucher disease type 2]]
*[[Glioma]]
*[[Glutathione synthase deficiency]]
*[[Glycine encephalopathy, atypical mild form]]
*[[GM2-gangliosidoses]]
*[[Granulomatous Angiitis of the Central Nervous System]]
*[[Griscelli disease]]
*[[Guillain-Barré syndrome]]
*[[Hallervorden-Spatz disease]]
*[[Hartnup Disease ]]
*[[Head trauma]]
*[[Heidenhain syndrome]]
*[[Hemangioblastoma]]
*[[Hepatocerebral degeneration]]
*[[Hereditary spastic paraparesis]]
*[[Hexosaminidase deficiency]]
*[[HIV infection]]
*[[Homozygous hypobetalipoproteinemia]]
{{ColBreak}}
*[[Hydrocephalus]]
*[[Hydroxyacyl-coa dehydrogenase, type 2, deficiency]]
*[[Hyperammonemia]]
*[[Hypogonadism]]
*[[Hypothyroidism]]
*[[Hysteria]]
*[[Infantile polymyoclonus]]
*[[Infantile sialic acid storage disorder]]
*[[Inherited neuropathies]]
*[[Insulinoma]]
*[[Joubert syndrome]]
*[[Juvenile pilocytic astrocytoma]]
*[[Kearns-Sayre Syndrome]]
*[[Krabbe leukodystrophy]]
*[[Kuru]]
*[[Lactic acidosis congenital infantile]]
*[[Lamotrigine]]
*[[Lantana poisoning]]
*[[Lead]]
*[[Levetiracetam]]
*[[Lhermitte-McAlpine syndrome]]
*[[Lipoamide dehydrogenase deficiency]]
*[[Lithium toxicity]]
*[[Machado-Joseph Disease]]
*[[Macrocytic anemia]]
*[[Macrogyria, pseudobulbar palsy and mental retardation]]
*[[Mann Syndrome]]
*[[Maple syrup urine disease]]
*[[Marinesco-Sjogren-like syndrome (MSLS)]]
*[[Marinescu-Garland Syndrome]]
*[[Mayapple poisoning]]
*[[Measles]]
*[[Medulloblastoma]]
*[[Meinecke syndrome]]
*[[Meningoencephalocele]]
*[[Mental retardation progressive spasticity, X-linked]]
*[[Mental retardation, X-linked, with cerebellar hypoplasia and distinctive facial appearance]]
*[[Mercury]]
*[[Mescal poisoning]]
*[[Metachromatic Leukodystrophy]]
*[[Metastatic insulinoma]]
*[[Metronidazole]]
*[[Mevalonic aciduria]]
*[[Miller Fisher Syndrome]]
*[[Minamata disease]]
*[[Mistletoe poisoning]]
*[[Mitochondrial cytopathy]]
*[[Mitochondrial encephalomyopathy]]
*[[Mononeuropathy/radiculopathy affecting the lower extremities]]
*[[Morgagni's Syndrome]]
*[[Morphine]]
*[[Multiple sclerosis]]
*[[Myelopathy]]
*[[Myoclonus]]
*[[Myopathy]]
*[[Neuronal intranuclear hyaline inclusion disease]]
*[[Niemann-Pick disease]]
*[[Normal pressure hydrocephalus]]
*[[Olivopontocerebellar atrophy]]
*[[Opsoclonus myoclonus syndrome]]
*[[Oxcarbazepine]]
*[[Paraneoplastic syndromes]]
*[[Parietal lobe lesion]]
*[[Parkinson's disease]]
*[[Partington X-linked mental retardation syndrome]]
*[[Pelizaeus-Merzbacher disease]]
*[[Pellagra-like syndrome]]
*[[Peripheral neuropathy]]
*[[Pernicious anemia]]
*[[Phenytoin toxicity]]
{{ColBreak}}
*[[Phosphoribosylpyrophosphate synthetase superactivity]]
*[[Polyneuritis]]
*[[Polyneuropathy]]
*[[Post-infective polyradiculopathy]]
*[[Posterior column ataxia with retinitis pigmentosa]]
*[[Posterior fossa tumor]]
*[[Primidone]]
*[[Progressive Multifocal Leukoencephalopathy]]
*[[Prolonged anoxia]]
*[[Purine nucleoside phosphorylase deficiency]]
*[[Pyruvate dehydrogenase deficiency]]
*[[Quaternary syphilis]]
*[[Ramsay-Hunt syndrome]]
*[[Reardon-Wilson-Cavanagh syndrome]]
*[[Refsum Disease]]
*[[Rett syndrome]]
*[[Revesz Debuse syndrome]]
*[[Rhombencephalosynapsis]]
*[[Richards-Rundle syndrome]]
*[[Roussy-Levy syndrome]]
*[[Rubinstein-Taybi syndrome]]
*[[Schroer-Hammer-Mauldin syndrome]]
*[[Segawa syndrome, autosomal recessive]]
*[[Selective vitamin E deficiency]]
*[[Shy-Drager syndrome]]
*[[Sialidosis type 1 and 3]]
*[[Smallpox]]
*[[Spastic paraplegia]]
*[[Spinal cord compression (and pressure on dorsal nerve roots)]]
*[[Spinal cord tumor]]
*[[Spinocerebellar ataxia]]
*[[Spinocerebellar degenerescence, book type]]
*[[sporadic ataxia]]
*[[SSADH deficiency (succinic semialdehyde dehydrogenase deficiency)]]
*[[Stroke]]
*[[Susac syndrome]]
*[[Tabes dorsalis]]
*[[Telencephalic leukoencephalopathy]]
*[[Thalamic syndrome]]
*[[Thallium poisoning]]
*[[Thiamine deficiency]]
*[[Thoracic dysplasia -- hydrocephalus syndrome]]
*[[Tick paralysis]]
*[[Tolterodine toxicity]]
*[[Toxic mushrooms -- Anticholinergic]]
*[[Toxic mushrooms -- Monomethylhydrazine]]
*[[Toxic mushrooms -- Psychedelic]]
*[[Tranebjaerg-Svejgaard syndrome]]
*[[Transient ischemic attack (TIA)]]
*[[Transthyretin amyloidosis]]
*[[Transverse myelitis]]
*[[Treft-Sanborn-Carey syndrome]]
*[[Triglyceride storage disease with impaired long-chain fatty acid oxidation]]
*[[Varnish makers' and painters' Naptha]]
*[[Vascular dementia]]
*[[Vertebral Artery Dissection]]
*[[Vertebrobasilar dolichoectasia]]
*[[Vertigo, benign paroxysmal, in childhood - ataxic gait]]
*[[Vitamin B12 deficieny]]
*[[Wernicke-Korsakoff psychosis]]
*[[Westphal's Disease]]
*[[Wilson's Disease]]
*[[Xeroderma pigmentosum]]
*[[Xylene]]
*[[Zinc deficiency]]
{{EndMultiCol}}
==Causes of ataxia==
The three types of ataxia have overlapping causes, and can therefore either coexist or occurr in isolation.
===Focal lesions===
Any type of focal lesion of the [[central nervous system]] (such as [[stroke]], [[brain tumour]], [[multiple sclerosis]] will cause the type of ataxia corresponding to the site of the lesion: cerebellar if in the cerebellum, sensory if in the dorsal spinal cord (and rarely in the [[thalamus]] or [[parietal lobe]]), vestibular if in the vestibular system (including the vestibular areas of the [[cerebral cortex]]).
===Exogenous substances===
Exogenous substances that cause ataxia mainly do so because they have a depressant effect on central nervous system function. The most common example is [[ethanol]], which is capable of causing overlapping cerebellar and vestibular ataxia. Other examples include both prescription drugs (e.g. most antiepileptic drugs have cerebellar ataxia as a possible unwanted effect) and recreational drugs (e.g. [[ketamine]], [[PCP]]).
===Vitamin B<sub><small>12</small></sub> deficiency===
[[cyanocobalamin|Vitamin B<sub><small>12</small></sub>]] deficiency may cause, among several neurological abnormalities, overlapping cerebellar and sensory ataxia.
===Causes of isolated sensory ataxia===
[[Peripheral neuropathy|Peripheral neuropathies]] may cause generalised or localised sensory ataxia (e.g. a limb only) depending on the extent of the neuropathic involvement. Spinal disorders of various types may cause sensory ataxia from the lesioned level below, when they involve the dorsal columns.
===Non-hereditary cerebellar degeneration===
Non-hereditary causes of cerebellar degeneration include chronic [[ethanol abuse]], [[paraneoplastic cerebellar degeneration]], [[high altitude cerebral oedema]], [[coeliac disease]], and [[normal pressure hydrocephalus]].
===Hereditary ataxias===
Ataxia may depend on [[hereditary]] disorders consisting of degeneration of the cerebellum and/or of the spine; most cases feature both to some extent, and therefore present with overlapping cerebellar and sensory ataxia, even though one is often more evident than the other. Hereditary disorders causing ataxia include [[autosomal dominant]] ones such as [[spinocerebellar ataxia]], [[episodic ataxia]], and [[dentatorubropallidoluysian atrophy]], as well as [[autosomal recessive]] disorders such as [[Friedreich's ataxia]] (sensory and cerebellar, with the former predominating), [[ataxia-telangiectasia]] (sensory and cerebellar, with the latter predominating), and [[abetalipoproteinaemia]]. An example of X-linked ataxic condition is the rare [[fragile X-associated tremor/ataxia syndrome]].
==Treatment==
There is no specific treatment for ataxia as such, altough there may be for the underlying cause. The disability of ataxia may be reduced by physical therapy, including exercises, along with leg braces or shoe splints, if foot alignment has been affected; a cane or walker is often used in the effort to prevent falls.
==References==
{{reflist|2}}
{{Symptoms and signs}}
{{SIB}}
[[de:Ataxie]]
[[es:Ataxia]]
[[es:Ataxia]]
[[fr:Ataxie]]
[[fr:Ataxie]]
[[it:Atassia]]
[[hu:Ataxia]]
[[nl:Ataxie]]
[[pt:Ataxia]]
[[pt:Ataxia]]
[[ru:Атаксия]]
[[ru:Атаксия]]
[[sr:Атаксија]]
[[fi:Ataksia]]
[[sv:Ataxi]]
[[uk:Атаксія]]
[[ur:لاتراتب]]
[[pl:Ataksja]]
[[pl:Ataksja]]


[[Category:Medical signs]]
[[Category:Signs and symptoms]]
[[Category:Signs and symptoms]]
[[Category:Neurology]]
[[Category:Neurology]]
[[Category:Needs patient information]]
 


{{WikiDoc Help Menu}}
{{WikiDoc Help Menu}}
{{WikiDoc Sources}}
{{WikiDoc Sources}}

Latest revision as of 17:05, 20 October 2020

Ataxia
ICD-10 R27.0
ICD-9 781.3

Ataxia Microchapters

Home

Patient Information

Overview

Classification

Pathophysiology

Causes

Differentiating Ataxia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Ataxia On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Ataxia

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

National Guidelines Clearinghouse

NICE Guidance

FDA on Ataxia

CDC on Ataxia

Ataxia in the news

Blogs onAtaxia

Directions to Hospitals Treating Ataxia

Risk calculators and risk factors for Ataxia

For patient information click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor in Chief: M.Umer Tariq [2]; Raviteja Guddeti, M.B.B.S. [3] Apeksha Gupta, MBBS[4]

Synonyms and keywords: Unsteady gait; ataxy; staggering gait; impaired coordination; lack of coordination; incoordination; incoordination of muscle movement

Overview

Classification

Pathophysiology

Causes

Differentiating Ataxia from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | CT | MRI | Other Imaging Findings | Other Diagnostic Studies

[1]

Treatment

The ataxia that occurs in children can often can go away in a few months without any treatment. In cases where an underlying cause is identified, the cause will be treated.

In some cases, you may have continuing and disabling symptoms. Treatment includes:

  • Corticosteroids
  • IV immune globulin
  • Plasma exchange therapy
  • Medications to improve muscle coordination

Occupational or physical therapy may also be needed. Changes to diet and nutritional supplements may also help.


Template:WikiDoc Sources

  1. ↑ de Silva R, Greenfield J, Cook A, Bonney H, Vallortigara J, Hunt B, Giunti P (February 2019). "Guidelines on the diagnosis and management of the progressive ataxias". Orphanet J Rare Dis. 14 (1): 51. doi:10.1186/s13023-019-1013-9. PMC 6381619. PMID 30786918.
Retrieved from "https://www.wikidoc.org/index.php?title=Ataxia&oldid=1670155"