Ataxia

“Ataxia” is an umbrella term for having uncoordinated movements. The word simply means “lack of coordination.” It’s a sign of a nervous system issue that can happen alongside other symptoms or as the main feature of a condition. Ataxia commonly involves difficulty walking and imbalance. But it can show up in other ways, possibly affecting other actions, depending on the underlying cause.

Ataxia has countless causes. Some are treatable or reversible, while others are permanent. It can develop at any age. Your healthcare provider can help you understand what ataxia means for you.

What does ataxia look like?

Ataxia can present in different ways depending on the type. It may involve:

• An unsteady, wide walking gait
• Difficulty controlling your arms and legs
• Swaying of your trunk
• Speech issues, like slurred speech (dysarthria) or a change in cadence or rhythm
• Difficulty swallowing
• Side-to-side eye movements (nystagmus)
• Loss of coordination that worsens when you close your eyes
• Issues with spatial awareness
• Using too little or too much force for actions
• Imbalance

Types

Because ataxia can happen for so many reasons, healthcare providers classify it in different ways.

The three main types of it, based on the location of the issue, include:

• Cerebellar: This type of ataxia happens because of a problem in the cerebellum, a part of your brain. Your cerebellum is in charge of posture, balance, muscle tone and the timing of voluntary movement.
• Sensory: Your body has a built-in “self-positioning” sense (proprioception), which lets your brain track where each body part is. Sensory ataxia disrupts this process.
• Vestibular: This type involves a problem with your inner ears, which help control your sense of balance. When your sense of balance is disrupted, it’s hard to coordinate how you move.

Providers also classify ataxia based on how it develops:

• Acquired: You develop it at some point in your life. For example, it may be a sign or complication of a cerebellar stroke. Some acquired cases are temporary or reversible, like ataxia due to a vitamin deficiency.
• Inherited: You inherit a condition that causes ataxia from one or both of your biological parents. Friedreich’s ataxia is the most common hereditary form. Episodic ataxia is another example.
• Sporadic: These cases of ataxia happen because of DNA changes that aren’t inherited. Sporadic ataxia typically develops in adulthood. One example is idiopathic late-onset cerebellar atrophy.

Causes of ataxia

In general, ataxia results from damage to your nervous system. In many cases, there’s an issue with your cerebellum or its connections. This is the part of your brain that’s responsible for coordinating your movements. In other cases, issues with your spinal cord or specific nerves (like your vestibulocochlear nerve) can cause ataxia.

Some examples of conditions or situations that can cause ataxia include:

• Alcohol use, especially alcohol use disorder
• Autoimmune conditions, like multiple sclerosis and celiac disease (gluten ataxia)
• Brain damage, like from a stroke, head trauma or tumor
• Degenerative conditions, like multiple system atrophy (MSA)
• Genetic disorders, like Friedreich’s ataxia, ataxia-telangiectasia and spinocerebellar ataxias
• Infections, especially viral infections in children
• Medication side effects, especially for certain sedatives, antiseizure medicines and chemotherapy drugs
• Toxins, like heavy metal poisoning and solvent poisoning
• Vitamin deficiencies, like low vitamin B12 or B1 levels

How is this symptom treated?

The treatment for ataxia depends on why it happens. Some cases may go away with minor treatment, like those related to alcohol use, gluten, viruses and medications.

Other causes, like genetic or degenerative conditions, aren’t reversible. So, it’s a matter of managing ataxia. For example, physical therapy can help with muscle strength, balance and coordination. And speech therapy can improve how you talk and swallow.

Because each case is different, your healthcare provider is the best person to tell you which treatments are likely to help you.

What are the possible complications or risks of not treating it?

Being unable to control your movements can disrupt your daily life. It can make everyday tasks difficult. This may lead to complications like depression and social isolation.

Physical complications of ataxia can include:

• Falling
• Breathing issues
• Choking
• Bone and joint changes, like scoliosis and high foot arches

Not everyone develops these complications. Your risk depends on the underlying cause of ataxia and its severity.

Life expectancy

Whether ataxia affects your lifespan depends on why it’s happening. Many of the causes of ataxia — especially the curable or temporary ones — won’t affect how long you live. But some causes, especially genetic forms of ataxia, can shorten your life expectancy.

Your healthcare provider will explain what effect, if any, ataxia may have on your lifespan.

Can ataxia be prevented?

Some causes of ataxia are preventable. But many of these happen unpredictably. Some ways you may be able to prevent acquired ataxia include:

• Avoiding alcohol or drinking it in moderation
• Avoiding substance use, especially huffing substances (toluene, gasoline, glue, spray paint and other inhalants)
• Eating nutritious foods to avoid vitamin deficiencies
• Managing stroke risk factors, like high blood pressure and diabetes
• Wearing a helmet to protect your brain from injury
• Wearing protective gear if you work with toxins
• Treating infections, especially ear infections, which can disrupt your sense of balance

When should this symptom be treated by a doctor?

Certain warning signs may mean ataxia is happening because of a more severe problem. You should talk to a healthcare provider if ataxia:

• Happens suddenly or you notice it getting worse over time
• Happens with certain symptoms, like headaches, nausea and vomiting
• Involves trouble swallowing, difficulty speaking or uncontrollable eye movements
• Lasts for more than a few days
• Interferes with your activities and routine

Get medical help right away if ataxia happens with any symptoms of a stroke.

What is the difference between ataxia and apraxia?

Ataxia and apraxia sound alike and do have many similarities. But there are also key differences:

• Apraxia: This condition affects your brain, making it hard for you to do or describe actions you already know how to do. It happens because your brain has issues processing these actions.
• Ataxia: This is a symptom that causes problems with coordinating muscle movements, affecting all actions (regardless of whether they’re new or familiar).