The Canadian Movement Disorder Group Ataxia The part of the brain that is involved in balance is at the back of the brain, attached to the
brainstem, and is called the "Cerebellum". Damage to the cerebellum or its connections will result in unsteadiness of walking, and clumsiness of hand and foot coordination.
Many conditions can cause the cerebellum to stop working normally.
Cause of Ataxia include a huge number of conditions: Drug / Toxin induced cerebellar dysfunction: These include drugs; Clonazepam, Tegretol, Phenobarb, Primidone, Dilantin and toxins including; acute alcohol intoxication, alcoholism, solvent abuse , lead / mercury Trauma to the cerebellum Head Injury Endocrine Disorders (diseases of the glands that release hormones) Hypothyroidism Nutritional Deficiencies Vitamin B12 deficiency Neoplastic (Tumor) Paraneoplastic (Associated with a distant tumor) Vascular Causes (Stroke) These include; vasculitis (inflamation of blood vessels eg. Lupus), angioblastoma (a tumor of the blood vessels), embolism (a blood clot plugging a blood vessel), hemorrhage (a blood vessel rupturing and bleeding into the cerebellum), and Von-Hippel-Lindau Syndrome (a disorder of blood vessel formation), Infectious Conditions Affecting the Cerebellum: These include; syphilis, A.I.D.S., cerebellar abscess, Coxsackie virus, Diptheria, Mumps, Polio, Typhus, Echovirus, Pertusis, Rubeola, Varicella, Infectious Mononucleosis, Mycoplasma, Infectious polyneuropathy, and Japenese B encephalopathy. Degenerative Neurologic Conditions: These include a large number of rare neurologic conditions as follows; Olivo-ponto-cerebellar Degeneration (O.P.C.A.), Spinocerebellar Ataxias (S.C.A.1,2,3,4,5,6,7), Acute Disseminated Encephalomyelitis, Acute Intermintent Cerebellar Ataxia, Ataxia (with Retinitis Pigmentosa, deafness, vestibullar abnormality, and intellectual dysfunction), Ataxia Telangiectasia, Cerebellar Ataxia (with deafness, anosmia, absent corneals, nonreactive pupils, and hyporeflexia), Dentate cerebellar atxia, Familial Ataxia with macular degeneration, Familial intention tremor, ataxia, lipofuscinosis, Friedreichs ataxia, Hereditary ataxia (with intellectual retardation, choreoathetosis, and eunuchoidism), Hereditary ataxia (with myotonia and cataracts), Hypertrophic interstitial neuritis, Marinesco-Sjogren Syndrome, Pelizaeus-Merzbacher disease, Periodic ataxia (with attacks of vertigo, diplopia, and ataxia), Ataxia (with posterior, and lateral column difficulties, with nystagmus and muscle atrophy), Progressive cerebellar ataxia and epilepsy, Ramsy Hunt syndrome, and Roussy-Levy syndrome Inherited Metabolic Defects listed below: Abetalipoprotienemia( Bassen-Kornzwieg Syndrome) Ataxia, retinitis, acanthocytosis, malabsorption, acanthocytes, low cholesterol, low Beta-Lipoprotein, and absent LDL's Arginosuccinic aciduria Siezures, hypotonia, hepatomegally, tufted friable hair, child onset, increasd Arginosuccinic acid in plasma Ceroid lipofuscinosis (Kufs Disease) Seizures, ataxia, myoclonus, dementia, Hypertension Exam shows cerebellar, pyramidal, and extrapyramidal signs Increased Lipopigments Ceroid, and Lipofuscin on brain biopsy, Peripheral leukocyte vacoules, and ceroid engorged vacuoles on conjunctival biopsy Gm2 gangliosidoses (Tay-Sachs)( Sandhoffs) Hyperacusis,myoclonus, seizures, developemental delay. Onset in first months of life. Very low levels of beta-hexosaminidase in serum, Leukocytes, and cultured fibroblasts Neutral amminoaciduria (Hartnup disease) Pellagra type rash, and intermittent ataxia, triggered by sunlight or stress. Hyperalaninemia Severe retardation, siezures, myoclonus, in childhood Ketoacidosis, and increased alanine in urine, and serum Hyperammonemia I and II; Increased ammonia Hypoglycemia Galactocerebrosidase Lipidosis Early oset of retardation, spasticity, siezures and optic atrophy (blindness). Unlikely to live past 2 years. Macrocephaly,peripheral neuropathy,hyporeflexia. Adult syndrome consists of leukodysrophy, cortical blindness, and spasticity. Peripheral neuropathy is rare. Dx B-gaclactocerebrosidase measurement. Maple suryp urine disease Rarely to live to age 5. Patients aquire spasticity, seizures, intermintant ataxia Dx sweet smelling urine, increased amino (branched) acids in urine. Metochromatic Leukodystrophy Patients aquire retardation, leukodystrophy, psychosis, and dementia Dx increased csf protein, peripheral neuropathy: Arylsulphatase def. Niemann-Pick disease Patients aquire retardation, seizures,ataxia Dx by finding "Sea Blue" histiocytes in bone marrow, supranuclear gaze palsy (upgaze) Vacuolated Lymphocytes, Sphingomyelinase def. Hereditary atactica polyneuritiformis (Refsum disease) Chronic neuropathy(motor and sensory (HMSN type IV), ataxia, increase csf protien,retinitis Dx increased serum Phytanic acid Tryptophanuria Ataxia, photosensitivity, short stature, and mental retardation Dx increased serum tryptophan Wernike encephalopathy Thiamine deficiency due to malnutrition, or Alcoholism Congenital (I.E. present at Birth) A variety of structural brain deffects can present as Ataxia including: Agenesis of vermis, Dysplasia, of cerebellum, Arnold-Chiari Malformation, Dandy Walker Malformation, Encephalocele, Platybasia and Hydrocephalus Primary Emotional (reaction to stress) Conversion reaction |