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Cerebellar ataxia: symptoms, causes and treatment

Cerebellar ataxia: symptoms, causes and treatment

March 28, 2024

Cerebellar or cerebellar ataxia is a set of symptoms related to the coordination of movements, balance and posture that occurs as a result of injuries and inflammations in the cerebellum. In this article we will describe the symptoms, causes and the main treatments of cerebellar ataxia .

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What is cerebellar ataxia?

The term "ataxia" is used to refer to a syndrome characterized by symptoms such as lack of balance and coordination motorboat. When these alterations are due to dysfunctions in the cerebellum, the posterior structure of the brain, the concept of "cerebellar ataxia" or "cerebellar" is used.

Although until a few years ago it was believed that the cerebellum participated mainly in functions related to the coordination of movement, nowadays it is known that it also plays a relevant role in language, in cognition and in emotion.

Because of this multiplicity of tasks, lesions and inflammations in the cerebellum not only cause ataxia but also other disparate symptoms that are associated with the processes and functions we have mentioned.

There are two main types of cerebellar ataxia : acute and chronic. We speak of "acute cerebellar ataxia" when the symptoms appear abruptly, and we say that it is chronic when they develop progressively.

Acute cerebellar ataxia is more frequent than chronic ataxia. It is common to appear in infants and young children in the period following an illness. Chronic cerebellar ataxia is usually associated with structural-type neurological alterations, such as those caused by trauma, tumors and autoimmune diseases.

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Symptoms and characteristic signs

The main symptoms of cerebellar ataxia are related to the coordination of movements of different parts of the body , since this type of signs are what define ataxia. However, the most common is that other alterations associated with damage to the cerebellum also appear.

Scientific research has determined that these symptoms and signs occur on the ipsilateral side of the organism, that is, in the same hemisphere in which the lesion is located in the cerebellum.

  • Lack of coordination (disynergy) of the trunk and extremities
  • Alterations in walking, frequent trips
  • Deficit in fine motor skills
  • Difficulties to execute fast and alternating movements (disdiadococinesia)
  • Lack of balance and postural alterations
  • Ocular nystagmus (involuntary movements of the eyes)
  • Instability of the look
  • Alterations in speech, mainly in the articulation of phonemes (dysarthria)
  • Difficulty swallowing food and fluids
  • Symptoms of depression and anxiety
  • Changes in behavior and personality
  • Sensations of dizziness
  • Late development of multiple systemic atrophy (in one third of patients)

Causes of this alteration

The cerebellum or any other part of the nervous system can suffer damage and inflammation for many different reasons; therefore, the reasons for the appearance of cerebellar ataxia are also very numerous.

Next we will describe some of the most habitual ones.

1. Genetic inheritance

There are different forms of ataxia caused by inheritance of genetic defects that alter protein synthesis necessary for the normal functioning of the nervous system, and that mainly affect the cerebellum and the spinal cord.

Spinocerebellar and episodic ataxias are inherited through an autosomal dominant mechanism, whereas Wilson's disease, Friedrich's ataxia, ataxia-telangiectasia and congenital cerebellar ataxia are transmitted by autosomal recessive inheritance.

2. Traumatic brain injuries

One of the most common causes of cerebellar ataxia is cranioencephalic trauma ; For example, it is common for the cerebellum to be damaged as a result of traffic accidents, when striking the back of the skull against the seat.

3. Cerebrovascular accidents

Strokes, such as ischemia, can alter circulatory flow to the cerebellum and other regions; If the tissue is devoid of nutrients and oxygen can be necrosed, which causes damage to the affected area.

4. Infectious diseases

Chickenpox, Lyme disease and other infectious diseases They are common causes of this syndrome, especially in young children. It usually appears in the recovery period and usually only lasts a few weeks.

5. Autoimmune diseases

Among the autoimmune diseases that can cause symptoms of cerebellar ataxia are multiple sclerosis and sarcoidosis.

6. Tumors in the brain

The appearance of tumors near the cerebellum often causes damage to this structure, even if it's benign tumors . Likewise, paraneoplastic syndromes, caused by pathological responses of the immune system to the development of cancer, have also been associated with cerebellar ataxia.

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7. Exposure and consumption of substances

Exposure to toxic elements to the human organism such as lead and mercury can cause symptoms of cerebellar ataxia; the same happens with chemotherapy. The abusive consumption of alcohol or some types of anxiolytics , especially barbiturates and benzodiazepines, can cause harmful reactions in the cerebellum and the rest of the nervous system.

Treatment of cerebellar ataxia

Since cerebellar ataxia can occur as a consequence of a large number of causes, the most appropriate treatment for each case will depend on the specific alteration that caused the symptoms. This multiplicity of causal factors makes the identification of the underlying problem particularly important in ataxia.

Acute cerebellar ataxias tend to disappear progressively in a matter of weeks; in the opposite way, and by definition, chronic ataxia is more difficult to treat and may have to be managed only through supportive therapy.

The rehabilitation can be effective to reduce the problems related to posture and motor skills. Therapeutic programs focused on exercises that work on coordination and balance are applied with certain frequency.

Buspirone, an anxiolytic group of azapirones , has been shown useful in the treatment of mild and moderate symptoms of cerebellar ataxia, although it is not so much in more severe cases. Its effects are associated with increased levels of serotonin in the cerebellum.

In recent years, research has begun on the therapeutic efficacy of transcranial stimulation of the cortex of the cerebellum in order to enhance its inhibitory activity on movements. The results so far are encouraging but more research is required to consolidate these interventions in cases of cerebellar ataxia.

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Study Finds Treatment Promises for Autoimmune Cerebellar Ataxia (March 2024).

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