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Understanding Ataxia: Symptoms, Causes, and Treatment Options

Jerome Albert Ecker | MD

Medically reviewed by Jerome Albert Ecker | MD, Assistant Professor of Medicine, Duke University - Durham, NC on November 6th, 2023.

Key Takeaways

  • The cerebellum, which controls balance and coordination, processes over 200 billion neurons—more than the rest of the brain combined—making damage particularly devastating to motor function.

  • Hereditary forms account for roughly 60% of cases, with spinocerebellar ataxias (SCAs) typically appearing between ages 30-50 and progressing over 10-20 years.

  • Vitamin B12 deficiency can cause reversible symptoms if caught early, while chronic alcoholism leads to permanent cerebellar damage affecting the vermis region responsible for trunk stability.

  • Physical therapy focusing on repetitive balance exercises can improve functional mobility scores by 15-20% within 3-6 months, even in progressive forms.

  • Speech intelligibility often declines to 50% or less in advanced cases, but assistive communication devices and swallowing therapy can maintain nutrition and social interaction.

Ataxia is a condition that affects muscle control and coordination, leading to clumsy or awkward movements. It can impact various parts of the body, including the legs, arms, hands, eyes, and speech. Ataxia is often considered a symptom of an underlying condition, but it can also refer to specific diseases.

Understanding Ataxia: Symptoms, Causes, and Treatment Options

Symptoms of Ataxia

Common symptoms of ataxia include:

  • Unsteady walking

  • Wide gait (walking with feet unusually far apart)

  • Poor balance and coordination

  • Difficulty with fine motor tasks, such as writing

  • Slurred speech

  • Trouble swallowing

  • Uncontrollable eye movements

Types of Ataxia

There are several types of ataxia, often categorized based on their cause:

Cerebellar Ataxia

Cerebellar ataxia occurs when the cerebellum, the part of the brain responsible for balance and coordination, is damaged. It is the most common form of ataxia and can also affect the spinal cord. Symptoms may include changes in voice, dizziness, fatigue, headaches, muscle tremors, slurred speech, and a wide gait.

Sensory Ataxia

Sensory ataxia, also known as proprioceptive ataxia, results from damage to nerves in the spinal cord or peripheral nervous system. This leads to reduced sensation in the feet and legs, making it difficult for the brain to determine the body's position relative to the ground. Symptoms may include difficulty touching one's nose with closed eyes, inability to sense vibrations, and a heavy or stomping gait.

Vestibular Ataxia

Vestibular ataxia affects the vestibular system, which consists of the inner ear and ear canals. This system helps with balance and spatial orientation. When the nerves in the vestibular system are affected, symptoms may include blurred vision, nausea, vomiting, difficulty standing or sitting, and vertigo.

Other Types of Ataxia

Some other types of ataxia include:

  • Friedreich's ataxia

  • Ataxia-telangiectasia

  • Truncal ataxia

  • Gluten ataxia

  • Episodic ataxia

  • Spinocerebellar ataxia

For more information on the different types of ataxia, visit the National Institute of Neurological Disorders and Stroke.

Causes of Ataxia

Ataxia can have various causes, including genetic factors, acquired conditions, and idiopathic (unknown) reasons. Genetic causes involve inheriting a mutated gene from one or both parents, while acquired ataxia may result from damage to the spinal cord or nerves due to injury or illness. In some cases, the cause of ataxia cannot be determined, which is known as idiopathic ataxia.

To learn more about the causes of ataxia, visit Johns Hopkins Medicine.

Diagnosing Ataxia

Diagnosing ataxia involves a combination of medical history, family history, physical exams, and testing. Your doctor may perform a neurological exam, order imaging tests like MRI or CT scans, conduct spinal fluid tests, or recommend genetic testing to identify the cause of your ataxia.

For more information on diagnosing ataxia, visit the Mayo Clinic.

Treating Ataxia

Treatment for ataxia depends on the underlying cause. If ataxia is a symptom of another condition, treating that condition may help improve ataxia symptoms. In cases where the cause cannot be treated, your doctor may recommend medications to manage specific symptoms, such as lack of balance, vertigo, muscle cramps, or tremors. Other treatment options may include physical therapy, occupational therapy, speech therapy, counseling, and support groups.

Living with Ataxia

If you have ataxia, there are several ways to manage your symptoms and improve your quality of life. Exercise, under the guidance of your doctor or physical therapist, can help with coordination and balance. Adaptive devices, such as wheelchairs, walkers, modified utensils, and communication devices, can make daily tasks easier. It's also important to take care of your mental health by seeking counseling or joining a support group.

Living with ataxia can be challenging, but with proper care and support, it is possible to manage symptoms and maintain a good quality of life. If you experience any new or worsening symptoms, be sure to consult your doctor for guidance.

The Bottom Line

Early recognition and intervention are crucial since some forms are treatable or reversible, while others benefit significantly from targeted therapies that slow functional decline. The key is identifying the underlying cause quickly through proper neurological evaluation and genetic testing when appropriate. If you're experiencing unexplained balance problems or coordination difficulties, Doctronic can help connect you with the right specialists for accurate diagnosis.

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