Ataxia, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications
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| Ataxia, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Ataxia is a movement disorder caused by problems in the brain. Ataxia can also be defined as a neurological disorder that affects the coordination of body movements, balance, and the ability to write, read, and speak.
Ataxia can cause limbs to move on their own or even be difficult to move. This condition can occur due to damage to the part of the brain that regulates muscle coordination. The cause can be due to disease, alcoholism, genetic factors, or consumption of certain drugs.
Treatment of ataxia aims to help patients move independently. The treatment method itself depends on the cause, it can be physical therapy or talk therapy.
Causes of Ataxia
Based on the cause, ataxia can be grouped into acquired ataxia, genetic ataxia, and idiopathic ataxia. The following is an explanation of each ataxia group:
Acquired ataxia
This group of ataxias occurs when the spinal cord and peripheral nerves are impaired due to injury or other disease. This condition can develop rapidly within a few days, or even hours.
Some of the causes of this type of ataxia are:
- Bacterial infections of the brain, eg meningitis or encephalitis
- Viral infections that can spread to the brain, such as chickenpox or measles
- Thyroid disorders, such as hypothyroidism and hypoparathyroidism
- Conditions that interfere with the supply of blood to the brain, such as a stroke or cerebral hemorrhage
- Severe head injury from a fall or accident
- Brain tumor or other types of cancer
- Cerebral palsy
- Autoimmune diseases, such as multiple sclerosis, sarcoidosis, or celiac disease
- Paraneoplastic syndrome, which is a disorder of the immune system due to cancer
- Hydrocephalus
- Deficiency of vitamin B1, B12, or E
- Toxic reactions or side effects of drugs, such as tranquilizers or chemotherapy drugs
- Alcohol addiction or drug abuse
Genetic ataxia
Genetic ataxia is ataxia that is passed down from parents. In this ataxia, there is an abnormality in certain genes that make the function of nerve cells in the brain and spine disrupted. As a result, nerve cells are damaged.
Types of genetic ataxia include:
- Spinocerebellar ataxia, which usually affects adults aged 25–80 years
- Episodic ataxia, which usually appears in adolescence
- Friedreich's ataxia, which usually occurs before the age of 25
- Ataxia telangiectasia, which is a progressive disease that usually occurs in children
- Congenital cerebellar ataxia, which is a condition caused by damage to the cerebellum at birth
- Wilson's disease, which usually appears in the teens
Idiopathic ataxia
Idiopathic ataxia is ataxia whose cause is unknown. In other words, this type of ataxia is not caused by a gene mutation, injury, or disease. However, it is suspected that idiopathic ataxia is triggered by a combination of genetic and environmental factors.
The most common type of idiopathic ataxia is multiple system atrophy.
Symptoms of Ataxia
Symptoms of ataxia can develop slowly or attack suddenly. Common symptoms of ataxia in the form of nervous disorders include:
- Poor movement coordination
- Unstable footsteps or like they are about to fall
- Body feels tired
- Difficulty doing simple activities, such as eating, writing, or getting dressed
- Change in speech
- Difficulty swallowing
- Nystagmus, which is abnormal eye movement
- Blurred vision
- Double vision
- Tremors in muscles
- Disturbances in thinking or controlling emotions
- Heart problems
Ataxia can occur in any area of the central nervous system. Depending on the location of the damage, ataxia can cause other symptoms. Here are some of these symptoms, according to the part of the nervous system that is damaged:
Cerebellar ataxia (cerebellum)
In this condition, damage occurs in the cerebellum or the cerebellum, which plays a role in balance or coordination. Cerebellar ataxia is characterized by the following symptoms:
- Voice change
- Dizzy
- Weak muscles or tremors
- Difficult to walk
- Slurred talk
- Walk with wide strides
Sensory ataxia
In sensory ataxia, damage can occur in the spinal cord or peripheral nervous system. Peripheral nerves or peripheral nerves are parts of the nervous system other than the brain and spinal cord.
Symptoms of sensory ataxia include:
- Numbness in the limbs
- Difficult to touch nose with closed eyes
- Can't feel the vibration
- Difficult to walk in dim light
- Heavy steps when walking.
Vestibular ataxia
Damage to this type of ataxia occurs in the vestibular system in the inner ear. The function of the vestibular system is to regulate head movement, body balance, and the body's ability to judge distance from surrounding objects.
Symptoms of ataxia in disorders of the vestibular system include:
- Impaired vision or blurred vision
- Nausea and vomiting
- Difficulty standing or sitting
- It's hard to walk straight
- Vertigo or dizziness
When to go to the doctor
Immediately consult a doctor if you experience the following symptoms:
- Loss of balance
- Decreased muscle coordination in the hands, arms, or legs
- Difficulty in walking, speaking clearly, and swallowing
Examination is highly recommended if you have never had a disease that can cause ataxia, such as multiple sclerosis.
Ataxia Diagnosis
The diagnosis of ataxia begins with questions and answers regarding the family history of ataxia, and the symptoms experienced by the patient. Next, the doctor will perform a physical and neurological examination, namely by checking the function of the patient's vision, hearing, balance, coordination, memory and concentration, as well as reflexes.
After that, the doctor will run additional tests to determine the cause of the ataxia, such as:
- Scans with X-rays, CT scans or MRIs, to identify abnormal conditions in the brain
- Lumbar puncture or cerebrospinal fluid examination, to detect infection
- Electromyography (EMG), to check the condition of nerves and muscle contractions
- Genetic testing by examining blood samples, to determine whether ataxia is caused by gene mutations
Ataxia Treatment
Treatment of ataxia is tailored to the cause. In ataxia caused by other diseases, the doctor will treat the disease first, for example:
- Provide vitamin supplements to treat ataxia due to vitamin deficiency
- Prescribing acetazolamide and advising patients to avoid trigger factors, such as stress, alcohol, and caffeine, to treat episodic ataxia
- Give antibiotics or antiviral drugs, to treat ataxia triggered by infection
Until now there is no method that can treat ataxia due to genetic disorders. However, several treatment methods can be used to relieve the symptoms, such as:
Drugs
Medications that can be given to relieve ataxia symptoms include:
- Baclofen and tizanidine, to treat muscle stiffness and cramps
- Botox injections (botulinum toxin), to cure muscle cramps
- Gabapentin, to control eye muscle movement.
AIDS
In patients with ataxia that cannot be cured, for example due to multiple sclerosis or cerebral palsy, the doctor will recommend the use of assistive devices. Some of these aids are walking sticks or supports, communication aids for speech, and modified eating utensils.
Glasses with prisms
Doctors can prescribe special glasses to help ataxia patients who have double vision.
In addition to the methods above, doctors can also perform therapy to help patients to be able to carry out daily activities independently, including:
- Physical therapy, to help coordination and increase the patient's flexibility in moving
- Speech therapy, to improve the ability to speak and swallow
- Occupational therapy, to assist patients in carrying out daily activities, such as eating alone
In addition to therapy, consulting with a therapist or joining a group with the same condition (support group) can help patients understand their condition and be motivated to recover.
Ataxia Complications
Complications that can occur due to ataxia can vary, depending on the type and symptoms experienced. In severe cases, ataxia can cause complications such as:
- Permanent body stiffness
- Difficulty breathing
- Choking that can lead to death
Meanwhile, in ataxia which causes sufferers to fall frequently or have to constantly sit in a chair or lie in bed, complications that may occur include:
- Injury
- Pressure injuries
- Infection
- Formation of blood clots
For people with heart problems due to ataxia, complications that can occur include:
- Cardiomyopathy
- Diabetes
- Impaired vision, sometimes can lead to blindness
- Hearing loss, including deafness
In addition, ataxia can also affect the patient's daily life, so that it can cause complications, such as:
- Depression
- Anxiety disorders
- Dementia
Ataxia Prevention
Prevention of ataxia depends on the type. Until now, ataxia that is inherited due to genetic disorders cannot be prevented. However, ataxia caused by other diseases can be prevented by avoiding these diseases. Some of the ways this can be done are:
- Ensure that children get complete vaccinations, one of which is a vaccine to prevent chickenpox
- Avoid excessive consumption of alcoholic beverages
- Reduce the risk of stroke by exercising, maintaining an ideal body weight, and controlling cholesterol and blood pressure levels
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