Ataxia

This page is for adult patients. For pediatric patients, see: ataxia (peds).

Background

  • Sign of a variety of disease processes; not a diagnosis in itself
  • Isolated lesion of cerebellum is NOT the most common cause
  • Must distinguish between motor (cerebellar) and sensory (cord, peripheral nerves) ataxia
    • Sensory ataxia may be compensated to a degree with visual sensory information

Clinical Features

  • Sensory (failure to transmit proprioception) versus motor (cerebellar) ataxia
    • Romberg test
      • Comparison of posture stability when eyes are open versus eyes closed
      • If ataxia worsens with loss of visual input suggestive of sensory ataxia
      • If ataxia does not significantly change with eyes closed suggests motor ataxia
    • Finger-to-nose, heel-to-shin, rapid alternating movements
      • If abnormal with eyes open, suggests motor ataxia
      • If abnormal with eyes closed, suggests sensory ataxia
  • Systemic versus isolated nervous system disease
  • CNS versus PNS

Differential Diagnosis

Evaluation

  • Depends on rapidity of symptoms and additional features
  • If acute consider CT, MRI, LP

Management

  • Treat underlying pathology

Disposition

See Also

References