Ataxia is a movement disorder caused by problems with the brain. When stricken with ataxia, a person has difficulty moving the body as desired or limbs can move when they are not wanted. In other words, ataxia also means a nervous or neurological disorder that affects coordination, balance, and speech.
Many conditions can cause damage to the part of the brain that regulates muscle coordination. These conditions can be alcohol addiction, disease, genetic factors, or consumption of certain drugs.
So far, found about 100 different types of ataxia. These types are grouped based on the cause and the part of the body that is disturbed. Treatment of ataxia depends on the cause and aims for the patient to carry out activities independently. Forms of treatment that can be done, including drug administration, physiotherapy, and talk therapy.
Symptoms of Ataxia
Symptoms of ataxia can develop slowly or attack suddenly. Common symptoms exhibited by nervous disorders, which include:
- Poor movement coordination.
- Unstable footsteps or like they are about to fall.
- Difficulty controlling fine motor skills, such as eating, writing, or buttoning a shirt.
- Change in speech.
- Difficulty swallowing.
- Nystagmus or involuntary eye movements. This eye movement can occur in one or both eyes that move sideways (horizontally), up-down (vertical), or rotate.
- Disturbances in thinking or emotions.
Ataxia can occur in any area of the central nervous system. Based on the location of the damage, ataxia is divided into:
- Cerebellar (cerebellar) ataxia. This condition occurs when damage occurs to the cerebellum or the cerebellum, which plays a role in balance or coordination. Cerebellar ataxia is indicated by symptoms such as changes in personality or behavior, muscle weakness or tremors, difficulty walking, slurred speech, or walking with wide strides.
- Sensory ataxia. Damage can occur to the spinal cord or peripheral nervous system. Peripheral nerves are part of the nervous system apart from the brain and spinal cord. Symptoms of sensory ataxia include numbness in the legs, difficulty touching the nose with eyes closed, not being able to feel vibrations, difficulty walking in dim light, or heavy steps when walking.
- Vestibular ataxia. This type of damage occurs in the vestibular system in the inner ear. The function of the vestibular system is to regulate head movement, body balance, and maintain body posture in a space (spatial). Symptoms of disorders of the vestibular system, including impaired vision or blurred vision, nausea and vomiting, problems standing or sitting, difficulty walking straight, and vertigo or dizziness.
Causes of Ataxia
Several conditions can cause ataxia. From the cause, ataxia can be classified into acquired ataxia (acquired ataxia).acquired ataxia), genetic ataxia, and idiopathic ataxia.
Acquired ataxia
This type of ataxia occurs when there is a disruption in the spinal cord due to injury or disease. Some of the causes include:
- Bacterial infections of the brain, eg meningitis or
- Viral infections that spread to the brain, such as chickenpox or measles.
- Lack of thyroid hormone in the blood.
- Conditions that interfere with blood supply to the brain, such as stroke or bleeding.
- Severe head injury after a fall or accident.
- Brain tumor.
- Cerebral palsy, or disorders due to brain damage during the growth of the child before or after birth, which affects the body's ability to coordinate movements.
- Autoimmune diseases, such as multiple sclerosissarcoidosis, or celiac disease.
- Paraneoplastic syndrome, which is a disorder of the immune system due to cancer.
- Hydrocephalus.
- Lack of vitamins B1, B12, or E.
- Toxic reactions or side effects of drugs, such as tranquilizers or chemotherapy drugs.
- Alcohol addiction or drug abuse.
Ataxia ggenetic
Genetic ataxia is ataxia that is inherited from parents. where there is an error in certain genes that make the function of nerve cells in the brain or spinal cord to be inhibited, causing nerve cell damage. There are several types of genetic ataxia, including:
- Ataxia due to dominant gene (autosomal dominant disorder). In this disorder, ataxia can be inherited even though the abnormal gene is inherited only from one parent. One that belongs to this group is spinocerebellar ataxia, which usually affects adults at the age of 25-80 years. Another type is episodic ataxia, which can be triggered by shock or sudden movement, as well as stress. The early symptoms of episodic ataxia can appear in adolescence.
- Ataxia due to a recessive gene (autosomal recessive disorder).In this disorder, both parents need to pass genes on to the child to cause ataxia. Some of these types of ataxia are:
- Friedreich's ataxia, which usually occurs before the age of 25.
- Ataxia telangiectasia, which is a rare progressive disease that occurs in children, and causes a decrease in brain function and the immune system.
- Congenital cerebellar ataxia, which is a condition caused by damage to the cerebellum at birth.
- Wilson's disease, which is characterized by a buildup of copper in the brain, liver, or other organs.
Idiopathic Ataxiak
The cause of this ataxia is unknown. In other words, this type of ataxia is not caused by a gene mutation, injury, or disease. Idiopathic ataxia includes: multiple system atrophy. This ataxia can occur due to a combination of environmental or genetic factors.
Ataxia Diagnosis
A diagnosis of ataxia can be made by a doctor after asking about symptoms and performing a physical examination, including a neurological examination. The examination includes looking at the condition of memory and concentration, vision, hearing, balance, coordination, and reflexes of the patient. In order to determine the cause of ataxia, the doctor may recommend additional tests, such as:
- Brain scan. To identify abnormal conditions in the brain that cause ataxia. Scans can be done via X-rays, CT scans or MRIs.
- Lumbar puncture. The doctor will examine the cerebrospinal fluid for abnormal conditions, such as infection, that cause the same symptoms as ataxia.
- Genetic testing. To determine whether ataxia is caused by gene mutations. The doctor will take a blood sample for examination.
Ataxia Treatment
Treatment for ataxia is based on the cause. For example, ataxia due to vitamin deficiency can be treated with vitamin supplements. Meanwhile, episodic ataxia can be treated with medication acetazolamide and avoiding trigger factors, such as stress. For ataxia acquired due to infection, it can be treated with antibiotics or antiviral drugs.
To relieve the disturbance experienced by people with ataxia, doctors may recommend:
- Drugs. The example is baclofen and tizanidine for muscle spasms and cramps, medicine sildenafil for erectile dysfunction, injections botulinum toxin to relieve muscle cramps, pain relievers for nerve pain (ibuprofen, paracetamol), as well as antidepressants for depressive disorders.
- Self-management for bladder disorders. For example, limiting fluid intake, setting a schedule for regular urination, and avoiding drinks that can increase urine production, such as caffeine or alcohol.
- Wearing glasses with prisms for patients with ataxia who have double vision.
For cases of ataxia caused by multiple sclerosis or cerebral palsy, cannot be cured. To make it easier for sufferers to carry out routine activities, doctors may recommend the use of assistive devices, such as walking sticks, communication aids for speech, and modified eating utensils.
In addition to overcoming the conditions that cause ataxia, doctors can also perform therapy to help sufferers to be able to carry out daily activities independently. The example is:
- physical therapy, to help coordination and increase the flexibility of the patient in carrying out movements.
- talk therapy, to improve speech and swallowing skills.
- occupational therapy, to assist patients in carrying out routine activities, such as feeding themselves.
In addition to therapy, consult with a counselor or join in support group can also help sufferers to find motivation and a better understanding of the ataxia condition experienced.