History and Background
Ataxia is a sign of dysfunction in the neurologc system. Ataxia can occur following a stroke, brain injury, or a hereditary disorder (freidrichs ataxia) and typically involves some sort of damage to the cerebellum. One function of the cerebellum is to serve as a coordination center. This complex system must receive information, interpret it, and quickly produce a response. The cerebellum is responsible for making sure the body is moving appropriately to complete a desired movement or activity.
What is the cerebellum?
The Cerebellum is in the back of the brain and is responsible for balance, coordination, and fine motor movements. It receives information from what the eyes see in the surrounding envirnment, the vestibular system (equilibrium centers), and from sensation from the body. It has to main responses. One is immediate and goes directly back to the body to make a quick adjustment. Another response goes to another motor planning center in the brain. This motor planning step is necessary for coordinated movements.
What Causes Cerebellar Ataxia?
Cerebellar ataxia is a symptom of a problem in the cerebellum. The following is a brief list of issues that may effect the cerebellym to function normally.
- Brain Tumor
- Brain Lesion (Multiple Sclerosis)
- Hereditary Disorders
- B12 Deficiency
How do I know if I have Cerebellar Ataxia?
A neurologist is knowledgeable in diagnosing cerebellar ataxia. Providing a thorough history can be extremely valuable. The following is a list of things to think about prior to your visit to the physician
- Thorough medical history: including childhood diseases (polio, meningitis….etc)
- Drug History (prescription and recreational)
- Alcohol use
- Family Medical History
- Recent falls
- History of sports activity (primarily contact sports)
Possible Dignostic Tests
- MRI: image of brain and spinal cord structures
- Angiogram: image of blood vessels and blood flow
Physical therapy will include functional training, balance retraining and coordination activities to improve quality of life and decrease risk of falls.
Occupational therapy will work on practicing activities of daily living including bathing, dressing, grooming….etc.
Finding the right physician who understands movement disorders and the neurologic system is important. A Neurologist or a physician of physical medicine (also called a physiatrist) are very knowledgeable in deciding medication is a viable treatment option.
Physical Therapy Management
A physical therapist will complete a thorough balance and movement assessment and identify the areas having the greatest impact on coordinated movement, balance, and gait. Once the therapist has identified the movement dysfunction, certain activities will be selected to force the impaired systems to have to organize in a way to complete the activities successfully.
Activities are graded to a level of difficulty that will force the brain to organize to successfully complete the task. With each successful completion of the task, the brain is copying its response (similar to a formula or a code). Each activity will require a certain number of “successful completions” to remember this code permanently. Eventually, the brain can recall this pattern independently to reproduce the same response when the specific situation presents itself in the future. Depending on the movement impairments, activities will include upper extremity reaching, hand and foot placement on targets, a variety of gait activities, and static and dynamic standing balance activities.