cerebellar ataxia

[dileep]

Is there any definite treatment for cerebellar ataxia?

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Ataxia is a neurologic symptom of incoordination. Ataxia is a symptom of 100s of neurologic diseases. Cerebelllar ataxia is one type of ataxia occuring due to a problem in the cerebellum, one of the structures in the brain involved in coordination (among other things). There are several causes of cerebellar ataxia and whether or not the ataxia can be treated depends on the cause. Below, a few types of ataxias will be discussed but this list is by no means comprehensive.

In general, ataxias could be divided into a few groups (1) those with a known external cause such as alcoholism or other medications or drugs (2) those that occur following infection (3) those that are neurodegenerative, due to loss of cerebellar cells because of a primary abnormality in cerebellar cells as opposed to an external cause such as infection (4) due to an inborn error metabolism and/or a genetic defect that disrupts metabolism in cerebellar cells (5) those that occur in the setting of cancer, known as "paraneoplastic ataxias", and (6) others

Regarding the cerebellar ataxias due to an external cause, in some cases symptoms resolve (sometimes physical therapy is needed). In some patients, cerebellar ataxia occurs following an infection that affects the nervous system, in which case it often resolves. Chronic alcoholism can cause cerebellar ataxia; stopping alcohol intake can improve the ataxia but if it is severe, some permanent symptoms may remain. In patients with cerebellar stroke, with intensive physical and occupational therapy over weeks to months, symptoms may become minimal and may even resolve completely. In patients with cerebellar ataxia due to a tumor in the cerebellum, removal of the tumor often improves ataxia significantly, though some remaining symptoms may persist due to removal of normal cerebellar tissue following surgery. And so on.

For the inborn errors of metabolism, some treatable examples include betalipoproteinemia, adrenomyeloneuropathy, cerebrotendinous xanthomatosis, familial vitamin E deficiency, maple syrup urine disease, pyruvate dehydrogenase deficiency, Refsum disease, and Wilson disease. Management typically relies on dietary modification, vitamin/cofactor supplementation, or drugs to reduce the load of the accumulating toxic metabolite, or removal of abnormal proteins from the blood by a procedure called plasmapharesis.

In cerebellar ataxia due to cancer, what is called a paraneoplastic process, with removal of the tumor and treatment with an intravenous medication or immunosuppresants, cerebellar function improves.

Other types of cerebellar ataxias that are genetic such as the large group of genetic disorders called "spino-cerebellar ataxias", Ataxia-telangiectasia, Friedreich ataxia, and other mitochondrial disorders are being studied, certain modifications may be helpful but there is not a cure.

With the episodic ataxias, which are due to a defect in ion channels, proteins that move ions into and out of cells, certain medications are helpful.

Thank you for giving me the opportunity to answer your question. I hope you find this information useful, good luck.

[dileep]

I am thankful for the apparently exhaustive categories of ataxia's informed to me. i am in the process of identifying my case to a particular category. I propose to visit NIMANS, banglore shortly for a concrete decision on the issue. Once again thank u for the valuable informations and devoting your precious time for helping others.
Dileep Agarwalla