Ataxia

Diagnosis

When diagnosing ataxia, your healthcare professional looks for a treatable cause. How quickly symptoms start and how they change over time also help guide diagnosis. You'll likely have physical and neurological exams. Your healthcare professional checks your vision, balance, coordination and reflexes. You also might need one or more of these tests:

• Blood tests. These might help find treatable causes of ataxia.
• Imaging studies. An MRI of the brain might help find the possible causes. An MRI can sometimes show shrinkage of the cerebellum and other brain structures in people with ataxia. It also may show other treatable findings, such as a blood clot or noncancerous tumor.
• Nerve tests. Tests that measure how well nerves and muscles work may be used if numbness, tingling or other sensory changes are present.
• A spinal tap, also known as lumbar puncture. This test may be helpful if an infection, swelling, also called inflammation, or certain diseases could be causing ataxia. A needle is inserted into the lower back between two bones to remove a small sample of cerebrospinal fluid. The fluid, which surrounds and protects the brain and spinal cord, is sent to a laboratory for testing.
• Genetic testing. Your healthcare professional might recommend genetic testing to see if a gene change may be causing a condition that leads to ataxia. Gene tests are available for many, but not all, hereditary ataxias.

Treatment

Ataxia treatment depends on the cause. If ataxia is caused by a condition such as vitamin deficiency or celiac disease, treating the condition may help improve symptoms. Some types of ataxia that develop after chickenpox or other viral infections may improve over time, especially in children.

Most types of ataxia do not have a cure. Treatment often focuses on managing symptoms, treating underlying causes when possible and helping people stay independent and safe.

People with Friedreich ataxia can be treated with an oral medicine called omaveloxolone (Skyclarys). The U.S. Food and Drug Administration approved the medicine for adults and teenagers 16 and older. In clinical trials, the medicine helped improve symptoms in some people.

People who take this medicine may have regular blood tests because omaveloxolone can affect liver enzymes and cholesterol levels. Potential side effects of omaveloxolone include headache, nausea, stomach pain, fatigue, diarrhea, and muscle and joint pain.

Symptoms such as stiffness, tremor and dizziness might improve with other medicines. Your healthcare professional also might recommend adaptive devices or therapies.

Adaptive devices

When ataxia cannot be fully reversed, adaptive devices may help with daily activities and reduce the risk of falls. They include:

• Hiking sticks or walkers for walking.
• Modified utensils for eating.
• Communication aids for speaking.

Therapies

You might benefit from certain therapies, including:

• Physical therapy to help with coordination and improve mobility.
• Occupational therapy to help with daily living tasks, such as feeding yourself.
• Speech therapy to improve speech and aid swallowing.

Therapies also may focus on fall prevention and safety, such as improving balance and making the home environment safer.

Some studies have found that aerobic and strength exercises may be helpful for some people with ataxia.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Coping and support

Living with ataxia or having a child with the condition can be challenging. For some people, having ataxia may lead to depression and anxiety. Talking with a counselor or therapist might help. Joining a support group for ataxia or for a condition causing ataxia may provide information and encouragement.

Support group members often know about the latest treatments and tend to share their own experiences. Your healthcare professional might be able to recommend a group in your area.

Preparing for your appointment

You're likely to start by seeing your healthcare professional. You may be referred to a doctor who is trained in brain conditions, called a neurologist.

Here's some information to help you get ready for your appointment.

What you can do

When you make the appointment, ask if there's anything you need to do in advance, such as fasting before having a specific test.

Make a list of:

• Your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began.
• Key personal information, including other conditions you have and family medical history.
• All medicines, vitamins or supplements you take, including the doses.
• Questions to ask your healthcare professional.

Take a family member or friend along, if possible, to help you remember the information you get.

For ataxia, basic questions to ask include:

• What is likely causing my symptoms?
• Other than the most likely cause, what are other possible causes?
• What tests do I need?
• Is my condition likely for a short time or ongoing?
• What's the best course of action?
• Are there devices that can help me with coordination?
• I have other health conditions. How can I best manage them together?
• Are there restrictions I need to follow?
• Should I see a specialist?
• Are there brochures or other printed material I can take with me? What websites do you recommend?
• Do you know of ataxia research studies I might participate in?

Don't hesitate to ask other questions.

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• When did your symptoms start?
• What was your first symptom?
• Do you notice your symptoms all the time, or every once in a while?
• What seems to improve your symptoms?
• What seems to worsen your symptoms?
• Have any family members had these types of symptoms?
• Do you use alcohol or drugs?
• Have you been exposed to toxins?
• Have you had a virus recently?

What you can do in the meantime

Don't drink alcohol or take legal or illegal drugs that may be sold on the street, also called recreational drugs. Doing so can make your ataxia worse.