Ataxia, also called cerebellar ataxia, includes different movement disorders that share a common element: difficulty or failure in muscle coordination.
People with ataxia also experience various difficulties in their movements, as a result of atrophy or disease in the cerebellum.
Let us remember that the cerebellum is the region of the brain responsible for organizing information from the senses, which allows us to move and balance; Thus, if there is an injury in this area, we can suffer ataxia.
But, what else do we know about ataxia? What other causes do we find? Are there different types of ataxia? What treatments can be used to address it? At , we tell you.
Ataxia: a disorder that affects coordination
According to Camacho, Simón and Mateos (2008), from the Hospital 12 de Octubre in Madrid, “ataxia” literally means “motor incoordination.” The concept defines a syndrome of imbalance-instability in gait.
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This imbalance causes an increase in the base of support and, in more serious cases, the inability to maintain standing or walking. Ataxia is also defined as a neurological disorder, which involves a decrease in the ability to coordinate our movements.
Thus, it is a disorder that affects the nervous system, and according to Camacho et al. (2008), usually affects the cerebellum or its connections, although it also occurs due to impairment of proprioceptive sensitivity (sensory ataxia, which characteristically worsens with eye closure). This last case, however, is somewhat more common in adults than in children.
Difficulties coordinating or walking
In this way, people with ataxia experience difficulties coordinating the muscles of the different parts of their body, which makes it difficult for them to perform different gestures or actions, as well as walking.
Generally, the most affected limbs are the arms, legs and hands. However, in some cases ataxia also affects swallowing or vision.
Symptoms and effects of ataxia
Ataxia can appear in isolation (primary ataxia), or as an underlying sign of different diseases, alterations or neurodegenerative disorders.
The symptoms of ataxia, as we have seen, include a lack of coordination in movements. Also, a certain imbalance when walking or simply staying in a certain place.
This imbalance can appear as a consequence of vestibular processes (accompanied by the sensation of vertigo), an injury to the frontal lobes or hydrocephalus. It can even appear temporarily in infants with a feverish outbreak, as a consequence of the functional immaturity of their cerebellum.
Types of ataxia
We find two types of ataxias, depending on their nature:
- Primary ataxias
- Secondary ataxias
Primary ataxias
This type of ataxia is neurodegenerative. This means that they get worse over time. They are usually ataxias of genetic origin.
Within primary ataxias we find two more subtypes of apraxias: dominant ataxias (their origin is a single genetic mutation) and recessive ataxias (they are more sporadic and manifest when there are two genetic mutations; in the father and in the mother, which person inherits).
Secondary ataxias
Secondary ataxias, or acute ataxias, are those that have diverse origins; Thus, they can arise as a consequence of an infection, a tumor, metabolic alterations, etc. The most common secondary ataxia is that caused by alcohol (excessive consumption of the substance).
Causes of acute ataxias
According to the cited article by Camacho et al. (2008), the most common causes of acute ataxias, especially in children, are:
- Post-infectious or immunologically based cause:
- Postinfectious cerebellitis
- Demyelinating diseases
- Opsoclonus-myoclonus syndrome
- Miller-Fisher syndrome
- Poisoning
- Central Nervous System (CNS) Infection
- Posterior fossa tumors
- Head trauma
- Basilar type migraine and migraine equivalents
- cerebrovascular pathology
- Hereditary diseases
- Psychogenic reaction
Other signs that accompany ataxia
Ataxia may be accompanied by other signs of cerebellar dysfunction. These signs or symptoms affect movement and include:
- Nystagmus: uncontrollable and involuntary movement of the eyes.
- Shaking: involuntary, somewhat rhythmic movement; contractions that involve oscillations or spasms of one or more parts of the body.
- Dysarthria: alteration in the articulation of words.
- Dysmetria: lack of coordination of movement typified by the inferior branch or excess of intended position with the hand, arm, leg or eye.
- Hypotonia: decreased muscle tone.
- Dysdiadochokinesia: inability to perform rapid alternating movements; affects time, speed and acceleration in normal movements.
Ataxia treatment
Currently there is no specific treatment that cures ataxia. However, there are treatments that can alleviate or reduce its “effects” or symptoms, which includes symptomatic control of pain or fatigue.
On the other hand, there are devices that improve the autonomy and quality of life of the person, such as walkers, canes, utensils adapted to help the person eat or carry out other basic activities of daily living, communication systems, etc.
Types of therapy
Physiotherapy can help patients with ataxia improve their coordination, balance, and overall mobility. Speech therapy is also useful for improving speech and swallowing, and occupational therapy improves the person’s autonomy in their daily tasks.
In addition, psychological therapy can be beneficial to work on the psychological and emotional aspects derived from the ataxia itself: insecurities, low self-esteem, fatigue, etc.
Finally, according to Manto and Marmolino, 2009, research in the development of animal models brings hope for better treatment of ataxias; in this case, primary or neurodegenerative ataxias.
Final synthesis
As we have seen, the term “cerebellar ataxias”, or cerebellar ataxia, according to Manto and Marmolino (2009), covers the various cerebellar disorders that affect motor coordination and balance.
According to the medical portal, ataxia “involves lack of muscle control or coordination of voluntary movements, such as walking or picking up objects.”
If it arises as a sign of an underlying condition, ataxia can affect various movements, in addition to creating difficulties when speaking, moving the eyes or swallowing.
References:
- Camacho, A., Simón, R. and Mateos, F. (2008). Acute ataxia. Child Neurology Section. Hospital 12 de Octubre, Madrid. Spanish Association of Pediatrics.
- Manto, M., and Marmolino, D. (2009). Cerebellar ataxias. Current opinion in neurology, 22(4): 419-429.
- Ryan MM, Engle EC. Acute ataxia in childhood. J Child Neurol 2003; 18:309