Ataxia

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What is ataxia?

In its most common use, ataxia is a neurological symptom. The definition of ataxia is a state of being without coordination or having abnormal, uncoordinated movements. The incoordination affects voluntary muscle movements. It can result in lack of balance, clumsiness, difficulty walking, stumbling, and an unsteady or staggering gait. Ataxia can also cause problems with fine motor movements, such as writing.

Ataxia can also describe a group of inherited, degenerative neurological disorders. However, ataxia as a symptom can be due to a variety of conditions. They range from infections to stroke to trauma to degenerative diseases, such as multiple sclerosis (MS). Certain medications and substances can also cause it. Sometimes, doctors can’t find a reason for ataxia.

In general, ataxia causes are related to the central nervous system, vestibular system, or peripheral sensory nerves. (Peripheral nerves are throughout the body, not including the brain and spinal cord.) Age, timing of onset, associated symptoms, and local or widespread involvement can help narrow down the underlying problem. Depending on the cause of ataxia, the lack of coordination may appear rather suddenly or develop slowly with time. The most common form of ataxia is from damage to the cerebellum, the part of the brain that allows for coordinated muscle movement and balance.

See your doctor if you develop problems with balance, coordination or walking. In some cases, the sudden appearance of ataxia can indicate a serious and potentially life-threatening condition. This includes stroke, poisoning and encephalitis. Seek immediate medical care (call 911) if you, or someone you are with, have sudden onset of serious symptoms including:

  • Confusion

  • Difficulty walking or talking

  • Facial drooping

  • Severe headache or dizziness

  • Uncoordinated body movements or inability to move a body part

  • Weakness or numbness

What other symptoms might occur with ataxia?

Other symptoms may accompany ataxia, depending on the underlying cause. These other symptoms will vary with the cause.

Other symptoms that may occur along with ataxia

Symptoms occurring with ataxia can give doctors clues to the cause. Symptoms that may also be present include:

Symptoms that might indicate a life-threatening or serious condition

The sudden onset of ataxia should be evaluated immediately in an emergency setting. It may be a sign of a serious or even life-threatening condition, including stroke. Seek immediate medical care (call 911) if you, or someone you are with, suddenly have serious symptoms including:

  • Changes in vision or vision loss

  • Confusion or memory loss

  • Facial drooping, particularly on one side of the face

  • Fainting, near fainting, or seizure

  • Numbness or paralysis on one side of the body

  • Severe headache, dizziness or weakness

  • Slurred speech, difficulty speaking, or difficulty understanding speech

What causes ataxia?

There are many possible causes of ataxia. In general, ataxia occurs when there is a problem with the central nervous system, vestibular system, or peripheral sensory nerves. Infections, degenerative diseases, and many other conditions can interfere with the normal functioning of these systems. In the central nervous system (brain and spinal cord), damage to the cerebellum in the brain is the most common cause of ataxia. It controls muscle coordination and balance. Another name for this type of ataxia is cerebellar ataxia.

The three systems work together to keep your body balanced and properly positioned in space. The vestibular system of the inner ear senses movements of your head and body and the position of your body. Along with your eyes, it relays this sensory information to your brain. Peripheral nerves also send signals to your brain to indicate the position and actions of your limbs and body. Your brain integrates and interprets all these signals to give you a sense of balance and equilibrium. A problem affecting any of these areas can result in ataxia, but cerebellar ataxia is the most common problem.

Autoimmune and inflammatory causes of ataxia

Ataxia may arise from autoimmune or inflammatory conditions including:

Genetic or hereditary ataxias

There are several rare hereditary ataxias including:

  • Ataxia telangiectasia

  • Episodic ataxia

  • Friedreich’s ataxia

  • Spinocerebellar ataxias

  • Wilson’s disease

Infectious causes of ataxia

Infectious causes of temporary ataxia include:

Metabolic and nutritional causes of ataxia

Metabolic disorders and nutritional deficiencies can cause ataxia including:

  • Hypoparathyroidism (underactive parathyroid gland)

  • Thyroid diseases

  • Vitamin B12 deficiency

  • Vitamin E deficiency

Pharmacologic causes of ataxia

Several types of medications can cause ataxia as a side effect including:

  • Antiarrhythmics, such as amiodarone (Cordarone)

  • Antiseizure medicines, such as carbamazepine (Tegretol) and phenytoin (Dilantin)

  • Barbiturates, such as phenobarbital

  • Benzodiazepines, such as diazepam (Valium)

  • Certain cancer chemotherapies

  • Cyclosporine (Gengraf, Neoral, Sandimmune)

  • Lithium (Eskalith, Lithobid)

Toxic causes of ataxia

Toxins, poisons, and substances in toxic amounts can cause ataxia including:

  • Alcohol

  • Carbon monoxide

  • Heavy metals, such as mercury, lead and thallium

  • Heroin

  • Organic solvents, such as toluene and benzene

Other causes of ataxia

Ataxia can also be caused by:

  • Brain tumors, including both cancerous and noncancerous masses

  • Cerebral palsy

  • Concussion and other head trauma

Serious or life-threatening causes of ataxia

In some cases, ataxia may be a symptom of a serious or life-threatening condition that should be immediately evaluated in an emergency setting. These include:

  • Encephalitis, meningitis, or brain abscess

  • Head trauma

  • Poisonings

  • Stroke and other vascular problems in the brain

Treatment of ataxia depends on the underlying condition. If the cause is treatable, ataxia may resolve with appropriate treatment. And some forms will likely resolve on their own, such as ataxia with a viral infection. However, some causes of ataxia result in long-term problems with balance and coordination. Adaptive devices and physical, occupational and speech therapies can help people cope with ataxia.

What are the potential complications of ataxia?

The root cause of ataxia will determine the prognosis and outlook for the future. Seeking help for problems with balance and coordination can help lower the risk of complications. With ataxia, complications can include:

  • Disability

  • Falls and injuries

  • Problems at work or school

  • Trouble with everyday activities, such as walking, driving and self-care

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Aug 30
  1. Acute Cerebellar Ataxia. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/ency/article/001397.htm 
  2. Ashizawa T, Xia G. Ataxia. Continuum (Minneap Minn). 2016 Aug;22(4 Movement Disorders):1208-26.
  3. Ataxia. Columbia University. http://www.columbianeurology.org/neurology/staywell/document.php?id=35869 
  4. Ataxia International Parkinson and Movement Disorder Society. https://www.movementdisorders.org/MDS/About/Movement-Disorder-Overviews/Ataxia.htm 
  5. Ataxia. Mayo Foundation for Medical Education and Research. https://www.mayoclinic.org/diseases-conditions/ataxia/symptoms-causes/syc-20355652 
  6. Ataxias and Cerebellar or Spinocerebellar Degeneration Information Page. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/All-Disorders/Ataxias-and-Cerebellar-or-Spinocerebellar-Degeneration-Information-Page 
  7. Balance Disorders. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/balance/pages/balance_disorders.aspx 
  8. Brunberg JA; Expert Panel on Neurologic Imaging. Ataxia. AJNR Am J Neuroradiol. 2008 Aug;29(7):1420-2.
  9. What Is Ataxia? Johns Hopkins University. https://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/ataxia/conditions/ 
  10. What Is Ataxia? National Ataxia Foundation. https://ataxia.org/what-is-ataxia/ 


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