ataxia Flashcards
dysfunction in which part of the brain is associated with ataxia?
the cerebellum
controls the timing and pattern of motor activity during movement
ataxio=lack of order
dysfunction of which cells are associated with dysfunction in ataxia?
purkinje cells
maybe insert diagram?
what are the symptoms of cerebellar dysfunction?
slurring of speech ( staccato)
oscilopsia
clumsiness
loss of movement precision
action tremor
unsteadiness when walking (worse in dark)
falls
cognitive problems
what are the signs of cerebellar dysfunction
gait ataxia truncal ataxia action tremor dysdiadochokinaesia nystagmus dysarthria
what is nystagmus?
abnormalities of eye movements
what are the 6 classifications of ataxias?
1) congenital (eg cerebellar dysgenesis
2) disease where ataxia is one of many features (usually autosomal recessive diseases)
3) episodic ataxias (eg EA1,1…)
4) autosomal recessive (FA)
5) autosomal dominant (eg SCAs)
6) sporadic ataxias (eg MSA-C, gluten ataxia)
does not include structural damage ataxia
what history features should be taken for ataxia?
age of onset
rate of progression
additional features (genito-urinary, postural)
pattern of involvement
detailed family history
alcohol intake
exposure to drugs toxic to the cerebellum
what examinations should be performed for ataxias?
eye involvement (nystagmus, broken pursuit)
limb ataxia
gait ataxia
symmetrical vs unilateral
evidence of peripheral neuropathy or sensory
neuronopathy (sensory ataxia)
evidence of postural blood pressure fall
what radiological investigation is useful for ataxias?
MRI imaging
to exclude: cerebrovascular damage primary tumours secondary tumours hydrocephalus MS white matter involvement in leukodystrophy cerebellar dysgenesis/malformations
list some causes of ataxia
Sporadic idiopathic sporadic gluten ataxia clinically probably MSA-C alcohol related paraneoplastic ataxia anti-GAD associated ataxia opsoclonus-myoclonu
in what percent of ataxia is no cause identified?
24%
