Cerebellar ataxia can occur as a result of many diseases and may present with symptoms of an inability to coordinate balance, gait, extremity and eye movements.[2] Lesions to the cerebellum can cause
dyssynergia,
dysmetria,
dysdiadochokinesia,
dysarthria and ataxia of stance and gait.[3] Deficits are observed with movements on the same side of the body as the lesion (ipsilateral).[2] Clinicians often use visual observation of people performing motor tasks in order to look for signs of ataxia.[2]
Signs and symptoms
Damage to the cerebellum causes impairment in motor skills and can cause
nystagmus. Almost a third of people with isolated, late onset cerebellar ataxia go on to develop
multiple system atrophy.[4]
The cerebellum's role has been observed as not purely motor. It is combined with intellect, emotion and planning.[5] Cerebellar deficits can be estimated using clinical rating scales, such as SODA for ocular deficits. [6]
Causes
A male with gluten ataxia: previous situation and evolution after 3 months of
gluten-free diet.
Primary auto-immune ataxias (PACA) lack diagnostic biomarkers.[10] Cerebellar ataxias can be classified as sporadic, autosomal recessive, X-linked, autosomal dominant and of mitochondrial origin. [11]
Treatment
"For many years, it was thought that postural and balance disorders in cerebellar ataxia were not treatable. However, the results of several recent studies suggest that rehabilitation can relieve postural disorders in patients with cerebellar ataxia...There is now moderate level evidence that rehabilitation is efficient to improve postural capacities of patients with cerebellar ataxia – particularly in patients with degenerative ataxia or multiple sclerosis. Intensive rehabilitation programs with balance and coordination exercises are necessary. Although techniques such as virtual reality, biofeedback, treadmill exercises with supported bodyweight and torso weighting appear to be of value, their specific efficacy has to be further investigated. Drugs have only been studied in degenerative ataxia, and the level of evidence is low."[12]
Some effects of cerebellar ataxia may be reduced to varying degrees by means of
Frenkel exercises.
Additionally, mild to moderate cerebellar ataxia may be treatable with buspirone.[15]
It is thought that the buspirone increases the serotonin levels in the cerebellum and so decreases ataxia.
Behavioral intervention
Behavioral intervention is successful when it involves engaging knowledge of the interests and general backgrounds of individuals with cerebellar ataxia. An intervention technique for speech is to focus on optimizing respiratory and vocal resources as well as training compensatory strategies.[16]
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abcFerrarin, M.; Gironi, M.; Mendozzi, L.; Nemni, R.; Mazzoleni, P.; Rabuffetti, M. (2005). "Procedure for the quantitative evaluation of motor disturbances in cerebellar ataxic patients". Medical & Biological Engineering & Computing. 43 (3): 349–56.
doi:
10.1007/BF02345812.
PMID16035223.
S2CID1307431.