The leman’s definition of ataxia is the improper muscle coordination that affects a person's ability to work, pick up objects, coordinate movement, the ability of speech, swallow and other voluntary movements. Many conditions are responsible for causing cerebellar ataxia in a person which include
- Multiple sclerosis
- Alcohol intake
- Cerebral palsy
- Head trauma
- Immunological disorders, and
In many cases, ataxia is also a result of autoimmune diseases.
Cerebellar ataxia includes identified, reversible as well as irreversible degenerative conditions. The irreversible degenerative condition causes a serious threat and affects the majority of the population.
The degenerative cerebellar ataxia is a group of disorders associated with progressive degeneration of the cerebellum. It results in impairment of both the axial motor control and the appendicular, because of the afferent and efferent pathways.
Hereditary Disorders Include
- Autosomal recessive mitochondrial transmission
- Autosomal dominant
- X linked pattern
The degenerative cerebellar ataxia is classified into three major groups and includes the
- Acquired ataxia resulting from toxins the vitamin deficiency
- Ataxia and immune-mediated disorders
- Superficial siderosis and
- Chronic central nervous system infections
These are further broken down into the hereditary and inherited degenerative ataxia.
Not all people suffer from an attack, some develop it over time and others result from another condition such as tumors, head injury excessive alcohol consumption or even a stroke. There is no specific period that can start it. It may start all of a sudden, and also stabilize itself in the human body. These factors also depend on the cause of cerebral ataxia.
The cerebellum present in the brain that plays a major role in coordinating sensory perception.
- Improper motor control results in cerebellar ataxia and other neurological symptoms, that include the ability to perform alternating movements, jerking, shaking the body.
- When trying to move the arms, there may be a lack of coordination between organs, muscles, and nerves, leading to a decrease in muscle zone and increased difficulty in estimating how much time has passed.
- It may also make it difficult to control distance, speed or any other form of movement.
- The extent of damage caused by cerebellar ataxia depends on whether the cerebellum is damaged damage is unilateral or bilateral. It affects majorly in a person and also changes a person's posture.
- If the vestibulocerebellum is affected due to ataxia, it can result in a complete loss of a person's balance and movement control. This forces a person to lose muscle coordination and they usually stand with their feet wide apart to gain better balance and avoid swaying back and forward.
- With cerebellar ataxia, a person may find it difficult to balance even where they are awake. It affects the spinocerebellum that causes unequal sideway steps. The person may start stuttering and stop all of a sudden.
- Ataxia affecting the cerebrocerebellum causes problems with voluntary arm movements. This may lead a person to tremble on the head, torso, have uncontrolled eye movements and also result in startling of speech with variations in volume and rhythm.
- Other types of attacks include sensory ataxia which is a primary result of the loss of proprioception. Proprioception is a person's ability to position the relative or neighboring parts of the body. It is the ability of a person to determine whether a body is moving with appropriate effort. Sensory ataxia results in heel striking hard to the ground and postural instability that worsens arm movement.
- Vestibular attack of the vestibular system of a person who plays a role in hearing can lead to vomiting, vertigo, and nausea. In bilateral cases, the slow onset of chronic bilateral case forces a person to experience unsteadiness, and finally reaches vestibulocerebellar ataxia.
Symptoms Of Cerebellar Ataxia
Disability and types of attacks determine the symptoms. The age of the person determines the causes, its features and can be present from birth. Injury and other health conditions may emerge at any point in a person's life. The symptoms that eventually appear and make it difficult for a person to conduct the activities include
- Improper limb coordination
- Speech problems resulting in slurring of speech and control volume and pitch
- Difficulty in balancing vision and hearing problems nystagmus an involuntary rhythmic repetitive eye movement
- Vision and hearing problems, tremors and trembling in parts of the body
- Children are also affected with ataxia, this form of ataxia is called ataxia-telangiectasia. The symptoms in a child may lead to spider veins in the whites of the eyes on the face and also frequent episodes of infections.
- A condition called Friedreich’s ataxia affects children from the age of 10 to 15 years and causes arching feet, sideward curvature of the spine or scoliosis where the heart muscles to get a week.
The Treatment Options Available For Cerebellar Ataxia
- Feud medication therapy
- Anti glutamine logic medication inhibits the glutamate receptors and closes the fast opening calcium channels. This further decreases the calcium itself of the body. Children who suffer from ataxia, have responded well to the symptoms of parkinsonism when amantadine 7-milligrams was prescribed per day.
- Nicotine receptor agonist, include varenicline known as an a4b2 nicotine receptor agonist. It helps in modulating the activity of the Purkinje cells, and granular cells these protect against glutamate-induced motor neuron disease.
- Serotonergic therapy inhibits the glutamatergic tone in the molecular layer of the cerebellum, thereby aiding in modulating the cerebellar in motor control. Patients prescribed with 10 milligrams of laevorotatory hydroxytryptophan showed improved results in serotonergic therapy and demonstrated positive measures in writing, speaking and gait.
The GABA drugs are mostly prescribed in adult patients with ataxia. They are known to stimulate Alpha to delta calcium channels enhancing GABA transmission. GABA analog binds Alpha to the delta subunit with calcium channels.
This has shown immediate improvement in patients after a single dose of 400 milligrams of gabapentin and again after 4 weeks of gabapentin with doses ranging from 900 to 1600 milligrams daily.
Ataxia patients suffering from vitamin E deficiency poses a challenge to a person's ability to use vitamin A resulting in symptoms of low doses of vitamin A. This leads to neurological movement and makes recovery slow, incomplete and results in vitamin D supplementation.
Cerebrotendinous mitosis is treated with chenodeoxycholic acid. Chenodeoxycholic acid is made naturally from bile acids and is crucial to prevent neurologic deterioration. Decarboxylase is treated with intravenous immunoglobulin or steroids.