Cerebellar ataxia: symptoms, causes and treatment

Cerebellar or cerebellar ataxia is a set of symptoms related to the coordination of movements, balance and posture that occurs as a result of injuries and inflammations in he cerebellum. In this article we will describe the symptoms, causes and the main treatments of cerebellar ataxia.

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What is cerebellar ataxia?

The term "ataxia" is used to refer to a syndrome characterized by symptoms such as lack of balance and coordination motorboat. When these alterations are due to dysfunctions in 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 participated mainly in functions related to coordination of movement, it is currently known that it also plays an important role in language, cognition and in the emotion.

Due to this multiplicity of tasks, lesions and inflammations in the cerebellum not only cause ataxia but also other disparate symptoms that are associated with the processes and functions we have mentioned.

There are two main types of cerebellar ataxia.: the acute and the chronic. We speak of "acute cerebellar ataxia" when the symptoms appear suddenly, and we say that it is chronic when they develop progressively.

Acute cerebellar ataxia is more common than chronic. It is common for it to appear in infants and young children in the period following an illness. Chronic cerebellar ataxia is often associated with structural neurological abnormalities, such as those caused by trauma, tumors, and autoimmune diseases.

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Characteristic symptoms and signs

The main symptoms of cerebellar ataxia They are related to the coordination of movements of different parts of the body, since these types of signs are those that define ataxia. However, the most common is that other alterations associated with damage to the cerebellum also appear.

Scientific research has determined that these symptoms and signs occur on the side ipsilateral to the organism, that is, in the same hemisphere as the lesion in the cerebellum.

• Lack of coordination (dyssynergia) of the trunk and extremities
• Gait disturbances, frequent stumbling
• fine motor deficit
• Difficulty executing rapid and alternating movements (dysdiadochokinesia)
• Lack of balance and postural changes
• Ocular nystagmus (involuntary eye movements)
• gaze instability
• Speech disorders, mainly in the articulation of phonemes (dysarthria)
• Difficulty swallowing food and liquids
• Symptoms of depression and anxiety
• Changes in behavior and personality
• dizzy sensations
• Late development of multiple system 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 numerous.

Below we will describe some of the most common.

1. Genetic heritage

There are different forms of ataxia caused by the inheritance of genetic defects that impair protein synthesis necessary for the normal functioning of the nervous system, and that mainly affect the cerebellum and the spinal cord.

Spinocerebellar and episodic ataxias are inherited through an autosomal dominant mechanism, while spinocerebellar disease Wilson, Friedrich's ataxia, ataxia-telangiectasia, and congenital cerebellar ataxia are transmitted by autosomal inheritance. recessive

2. Head injuries

One of the most common causes of cerebellar ataxia is head injury.; For example, it is common for the cerebellum to be damaged as a result of traffic accidents, when the back of the skull hits the seat.

3. cerebrovascular accidents

Strokes, like ischemia, can alter circulatory flow to the cerebellum and other regions; if the tissue is deprived of nutrients and oxygen it can become necrotic, which causes damage to 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 frequently causes damage to this structure, even if they are benign tumors. Similarly, paraneoplastic syndromes, caused by pathological responses of the immune system to the development of cancer, have also been associated with cerebellar ataxia.

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7. Exposure and consumption of substances

Exposure to toxic elements for the human organism such as lead and mercury can cause symptoms of cerebellar ataxia; the same is true of chemotherapy. The abusive consumption of alcohol or some types of anxiolytics, especially 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 as a consequence of a large number of causes, the most appropriate treatment in each case will depend on the specific disorder that has caused the symptoms. This multiplicity of causative factors makes identification of the underlying problem particularly important in ataxia.

Acute cerebellar ataxias tend to disappear progressively. in a matter of weeks; conversely, and by definition, chronic ataxia is more difficult to treat and may need to be managed solely by supportive therapy.

Rehabilitation can be effective in reducing problems related to posture and motor skills. Therapeutic programs focused on exercises that work coordination and balance are applied with some frequency.

Buspirone, an anxiolytic from the group of azapirones, has been shown to be useful in the treatment of mild and moderate symptoms of cerebellar ataxia, although it is not so useful in more severe cases. Its effects are associated with increased serotonin levels in the cerebellum.

In recent years, research has begun on the therapeutic efficacy of transcranial stimulation of the cerebellar cortex in order to enhance its inhibitory activity on movements. The results so far are encouraging but more research is required to consolidate these interventions in cases of cerebellar ataxia.

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