DEAR DR. ROACH: I've been told I have ataxia. What is it? — R.M.

ANSWER: Ataxia is a particular type of loss of muscular coordination. In adults, ataxia is generally caused by damage to the cerebellum, a large structure in the back of the brain that coordinates and regulates movement.

Symptoms include loss of balance, loss of motor coordination, gait changes, slurred speech and difficulty swallowing. The diagnosis of ataxia is made by a careful physical exam done by an expert, such as a neurologist.

There are many specific causes (140 or so listed in my textbook), and so the time and acuity of onset is a big clue to help determine the cause. Ataxias can be associated with drugs and toxins: Alcohol is probably the most common I see, but I have seen ataxia with amiodarone for heart rhythms, with lithium and valium-like drugs, and with chemotherapy.

There are many genetic or hereditary disorders with ataxia with variable ages of onset; the list includes mitochondrial diseases; infectious causes; circulatory problems, including stroke; trauma; tumors; autoimmune diseases; and degenerative neurological diseases.

There are a few treatable conditions to consider, including celiac disease, hypothyroidism and deficiency of vitamin E, B12 or thiamine. Wilson's disease, an accumulation of copper, is yet another cause.

 

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