Cerebellar ataxia or cerebellum is a collection of symptoms related to the coordination of movement, balance and posture that occur as a result of injury and inflammation of the cerebellum. In this article we will describe the symptoms, causes and the main treatments for cerebellar ataxia.
What is cerebellar ataxia?
The term “ataxia” is used to denote a syndrome characterized by symptoms such as lack of balance and coordination engine. When these alterations are due to dysfunctions of 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 was primarily involved in functions related to the coordination of movements, it is now known to play an important role in language, cognition and emotions as well.
Due to this multiplicity of tasks, injury and inflammation of the cerebellum not only causes ataxia, but also other disparate symptoms 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 symptoms appear suddenly, and we say that it is chronic when they develop gradually.
Acute cerebellar ataxia is more common than chronic. It is common in infants and young children in the period following illness. Chronic cerebellar ataxia is linked to structural-type neurological disorders, such as those caused by trauma, tumors and autoimmune diseases.
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Symptoms and characteristic signs
The main symptoms of cerebellar ataxia they concern the coordination of movements of different parts of the bodyAs these types of signs are what defines ataxia. However, other disorders associated with brain damage also appear more frequently.
Scientific research has determined that these symptoms and signs occur on the ipsilateral side of the body, that is, in the same hemisphere in which the lesion is located in the cerebellum.
- Lack of coordination (disinergy) of the trunk and limbs
- Gait alterations, frequent movement
- Fine motor impairment
- Difficulty performing rapid and alternating movements (dysdiadocokinesia)
- Lack of balance and postural alterations
- Ocular nystagmus (involuntary eye movements)
- Instability of gaze
- Speech alterations, mainly in the articulation of phonemes (dysarthria)
- Difficulty swallowing food and fluids
- Symptoms of depression and anxiety
- Behavior and personality changes
- Dizzying sensations
- 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 be damaged and inflamed from many different causes; therefore, the reasons for the appearance of cerebellar ataxia are also very many.
Below we will describe some of the most common.
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 mainly affecting the cerebellum and spinal cord.
Spinocerebellar and episodic ataxias are inherited by an autosomal dominant mechanism, while Wilson’s disease, Friedrich’s ataxia, ataxia-telangiectasia, and congenital cerebellar ataxia are inherited by autosomal recessive inheritance.
2. Cranioencephalic trauma
One of the most common causes of cerebellar ataxia is traumatic brain injury; for example, it is common for the cerebellum to be damaged as a result of traffic accidents, by hitting the back of the skull against the seat.
Strokes, such as ischemia, can alter circulatory flow to the cerebellum and other areas; if the tissue is deprived of nutrients and oxygen, it can necrosis, which damages the affected area.
4. Infectious diseases
Chickenpox, Lyme disease and other infectious diseases 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
Autoimmune diseases that can cause symptoms of cerebellar ataxia include multiple sclerosis and sarcoidosis.
6. Brain tumors
The appearance of tumors near the cerebellum often causes damage to this structure, even if they are benign tumors. Paraneoplastic syndromes, caused by pathological responses of the immune system to the development of cancer, have also been associated with cerebellar ataxia.
7. Exposure and use of substances
Exposure to elements toxic to the human body such as lead and mercury can cause symptoms of cerebellar ataxia; the same goes for chemotherapy. Heavy use of alcohol or certain types of anti-anxiety drugs, In particular 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 appear to be the consequence of a large number of causes, the most appropriate treatment in each case will depend on the specific alteration causing the symptoms. This multiplicity of causal factors makes the identification of the underlying problem particularly important in ataxia.
Acute cerebellar ataxias tend to go away gradually in a few weeks; conversely, and by definition, chronic ataxia is more difficult to treat and may need to be managed only with supportive therapy.
Rehabilitation can be effective in reducing posture and motor problems. Therapeutic programs focusing on coordination and work-balance exercises are applied with some frequency.
Buspirone, an anxiolytic from the azapiron group, Has been shown to be useful in the treatment of mild to moderate symptoms of cerebellar ataxia, although not so much in more severe cases. Its effects are associated with increased serotonin levels in the cerebellum.
In recent years, research has started therapeutic efficacy of transcranial stimulation of the cerebellar cortex in order to potentiate its inhibitory activity on movements. The results to date are promising, but more research is needed to consolidate these interventions for cerebellar ataxia.