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ATAXIA and Multiple Sclerosis

Posted Oct 19 2010 12:00am
ATAXIA affects so many of us with MS, that I had to post this information which I obtained from Multiple

Ataxia is incoordination caused by  dysfunction  to sensory nerve inputs, motor nerve outputs or the processing of them. It is not the result of  muscular weakness . Ataxia is most often applied to unsteadiness in walking but it also refers to upper body incoordination and dysfunction in eye movements and speech.
Ataxia is common in  multiple sclerosis  but is also seen in several other conditions including diabetic polyneuropathy, acute transverse myelitis, vacuolar myelopathy, tumor or cord compression and hereditary forms of ataxia.
There are three types of ataxia, all of which are seen in MS
  1. Cerebellar Ataxia
  2. This is caused by lesions in the  cerebellum  or in the parts of the  brain  that connect to it, such as the cerebellar peduncles, the  pons  or the red nucleus
    Because the cerebellum is responsible for synchronising voluntary muscle movement throughout the body, cerebellar ataxia can result in:  
    • Uncoordinated walking -  gait ataxia .
    • Reduced control of range of movement such as over- or under-shooting targets -  dysmetria .
    • Inability to maintain a steady posture -  hypotonia .
    • An inability to maintain a steady rhythm -  dysdiadochokinesia .
    • Shaking when attempting fine movements -  intention tremor .
    • An inability to coordinate the muscles involved in speech -  dysarthria .
    • Jittery eye movements -  nystagmus .

  3. Vestibular Ataxia
  4. In multiple sclerosis, vestibular ataxia is caused lesions to  brainstem  and the vestibular nuclei. In other conditions, it can also result from damage to the eighth cranial nerve  leading from the balance organs in the inner ear. Vestibular Ataxia can result in:
    • Loss of balance.
    • Dizziness, nausea and vomitting -  vertigo .
    • Jittery eye movements -  nystagmus .

  5. Sensory (Proprioceptive) Ataxia
  6. This results from dysfunction to position sensing (proprioceptive) nerve inputs. This means that the brain is confused as to the position of limbs. Sensory Ataxia results in:
    • Loss of position sense - not knowing exactly where your limbs hands and feet are.
    • The inability to detect vibrations.
    • An unstable stance -  Romberg's sign .
This table shows the main characteristics of the three forms of ataxia (after  Carlos Eduardo Reis )  
DysarthriaMay be presentAbsentAbsent
NystagmusOften presentPresentAbsent
VertigoMay be presentPresentAbsent
Limb ataxiaUsually presentAbsentPresent(only in the legs)
StanceUnable to stand with feet togetherMay be able to stand with feet togetherAble to stand with feet together and eyes open, but unable with eyes closed
Vibratory and position senseNormalNormalImpaired
Ankle reflexesNormalNormalDepressed or absent

Ataxia Links MedStudents - Neurology
Ataxias: Classification
Multiple Sclerosis Glossary: Ataxia
GeneClinics: Ataxia Overview
Movement, uncoordinated - Overview
Sensory: Large Fiber
Effect of Cannabinoids on Spasticity and Ataxia in Multiple Sclerosis

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