What is ataxia and what causes it? Types of ataxia depending on the location of the lesion Progressive ataxia.

Vestibular ataxia is a type of ataxia that results in dysfunction of the vestibular system. The vestibular system consists of the inner ear canals, which contain fluid.

They sense head movements and help with balance and spatial orientation. Vestibular ataxia is a consequence of a disorder of the inner ear.

Signals from the inner ear are unable to reach the cerebellum and brain stem when a person has vestibular ataxia. A person with vestibular ataxia experiences a loss of balance while maintaining strength. The patient often experiences dizziness, a feeling that everything around is spinning. Shows loss of balance or involuntary eye movement.

In unilateral or acute cases the anomaly is asymmetrical, the patient experiences nausea, vomiting, and dizziness. In slow chronic bilateral cases it is symmetrical, the person only feels an imbalance or instability.

There are many types of ataxia. In this article we will discuss some of the most common types, causes and available methods treatment.

Fast Facts

Ataxia is caused wide range factors.

• Symptoms include poor coordination, slurred speech, tremors, and hearing problems.
• Diagnosis is complex and often requires a series of studies.
• It is not always curable, but symptoms can often be relieved.

It belongs to a group of disorders that affect coordination, speech, and balance. Makes it difficult to swallow and walk.

Some people are born with it, others develop the syndrome slowly over time. For some it is the result of another condition, such as a stroke, multiple sclerosis, brain tumor, head injury or.

It gets worse or stabilizes over time. It partly depends on the cause.

Types

The following are some of the most common types of ataxia:

Cerebellar ataxia

The cerebellum is responsible for sensory perception, coordination and motor control.

Caused by dysfunction of the cerebellum, an area of ​​the brain involved in assimilation sensory perception, coordination and motor control.

Cerebellar ataxia provokes neurological problems such as:

• lethargy;
• lack of coordination between organs, muscles, limbs, joints;
• weakened ability to control distance, power, speed of movement of arms, legs, eyes;
• it is difficult to estimate exactly how much time has passed;
• inability to perform fast, alternating movements;

The extent of symptoms depends on which parts of the cerebellum are damaged, and whether there is damage on one side (unilateral) or on both sides (bilateral).

If the vestibular system is affected, balance control of the face and eyes will be impaired. The person stands with their feet wide apart to gain better balance and avoid rocking back and forth.

Even when the patient's eyes are open, balance when bringing the legs together is difficult.

If the cerebellum is affected, the patient will have an unusual gait with uneven steps, and stuttering begins and stops. Spinocerebellum regulates body position and limb movement.

If the deep structures of the brain are affected, the person will have problems with voluntary movements. The head, eyes, limbs, and torso may tremble when walking. Speech is slurred, with changes in rhythm and volume.

Sensory ataxia

Appears due to loss of proprioception. Proprioception is the sense of the relative position of neighboring parts of the body. Indicates whether the body is moving with the required force and provides feedback regarding the position of its parts relative to each other.

A patient with sensory ataxia typically has an unsteady stomping gait, with the heel striking hard as it hits the ground with each step. Postural instability worsens in low light conditions.

If the doctor asks you to stand with your eyes closed and your feet together, the instability will get worse. This is because the loss of proprioception makes a person much more dependent on visual input.

It is difficult for him to perform smoothly coordinated movements of the limbs, torso, pharynx, larynx, and eyes.

Cerebral ataxias

Early onset cerebellar ataxia usually occurs between the ages of 4 and 26 years. Late appears after the patient has reached 20. Late is characterized by less severe symptoms compared to early.

Ataxia is a violation of coordination of movements and motor skills.

With this disease, strength in the limbs is slightly reduced or completely preserved. Movements are imprecise, awkward, their sequence is disrupted, and it is difficult to maintain balance when walking or standing.

If balance is disturbed only in a standing position, they speak of static ataxia.

If coordination disturbances are noted during movement, then this is dynamic ataxia.

Types of ataxia

There are several types of ataxia:

1. Sensitive. The occurrence of the disorder is caused by damage to the posterior columns, less often - to the posterior nerves, peripheral nodes, cortex of the parietal lobe, thalamus. The disease can occur in all limbs, or in just one arm or leg. Sensitive ataxia manifests itself most clearly in the disorder of joint-muscular sensations in the legs. The patient has an unsteady gait, bends his knees excessively or steps too hard on the floor when walking. Sometimes it feels like walking on a soft surface. Patients compensate for the violation motor function through vision - when walking, they constantly look at their feet. Severe lesions of the posterior columns render the patient virtually unable to stand or walk.
2. Vestibular. Develops when one of the sections of the vestibular apparatus is damaged. The main symptom is systemic dizziness. It seems to the patient that surrounding objects are moving in one direction; when turning the head, this sensation intensifies. The patient avoids sudden head movements and may stagger erratically or fall. Vestibular ataxia may cause nausea and vomiting. The disease accompanies brainstem encephalitis, tumor of the fourth ventricle of the brain, Meniere's syndrome.
3. Cortical. Appears when the frontal lobe of the brain is damaged, caused by dysfunction of the fronto-pontocerebellar system. In this condition, the leg opposite the affected hemisphere suffers the most. Walking is characterized by instability (especially when turning), bending or leaning on one side. At severe defeat the patient cannot walk or stand. This type of ataxia is also characterized by the following symptoms: impaired sense of smell, changes in the psyche, and the appearance of a grasping reflex.
4. Cerebellar. With this type of ataxia, the cerebellum, its hemispheres or legs are affected. When walking, the patient falls over or falls. When the cerebellar vermis is damaged, the fall occurs to the side or backward. The patient staggers when walking and spreads his legs wide. Movements are sweeping, slow and awkward. Speech function may also be impaired - speech becomes slow and drawn out. The patient's handwriting is splayed and uneven. Sometimes there is decreased muscle tone.

Cerebellar ataxia manifests itself in malignant tumors.

Features of cerebellar ataxia syndrome

The main difference between cerebellar lesions is evidence of hypotonia in the ataxic limb(decreased muscle tone). At In cerebellar disorders, symptoms are never limited to a specific muscle, muscle group, or individual movement.

It has a widespread character.

Cerebellar ataxia has characteristic symptoms:

• impaired gait and standing;
• impaired coordination of limbs;
• intention tremor;
• slow speech with separate pronunciation of words;
• involuntary oscillatory eye movements;
• decreased muscle tone.

Hereditary ataxia of Pierre Marie

Cerebellar ataxia of Pierre Marie - hereditary disease, characterized by a progressive nature.

The likelihood of the disease manifesting itself is high - skipping generations is extremely rare. A characteristic pathological sign is cerebellar hypoplasia, which is often combined with degeneration spinal systems.

The disease most often begins to manifest itself at the age of 35 in the form of gait disturbances. Then it is joined by speech and facial expression disorders, ataxia upper limbs.

Tendon reflexes are increased, and involuntary muscle twitches occur. Strength in the limbs decreases, oculomotor disorders progress. Mental disorders manifest themselves in the form of depression and decreased mental activity.

What causes the pathology?

The causes of the disease may be:

1. Drug intoxication(lithium drugs, antiepileptic drugs, benzodiazepines), toxic substances. The disease is accompanied by drowsiness and confusion.
2. Cerebellar stroke, early detection which can save the patient's life. The disorder occurs due to thrombosis or embolism of the cerebellar arteries.
3. Manifests itself in the form of hemiataxia and decreased muscle tone on the affected side, headache, dizziness, impaired mobility eyeballs, impaired facial sensitivity on the affected side, weakness of facial muscles.
4. Cerebellar hemiataxia may be a consequence of developing medulla oblongata infarction, caused by .
5. Infectious diseases. Cerebellar ataxia often accompanies viral encephalitis and cerebellar abscess. IN childhood after viral infection(for example, after chickenpox) may develop acute cerebellar ataxia, which is manifested by gait disturbance. This condition usually ends full recovery for several months.

In addition, pathology can be a consequence of:

• lack of vitamin B12.

The manifestation of the disease cannot be missed

The main symptom of cerebellar ataxia is static violations. The characteristic posture of the patient in a standing position is legs wide apart, balancing with arms, avoiding turns and bending of the body.

If you push the patient or move his leg, he will fall without even noticing that he is falling.

With dynamic disorders, the disease manifests itself in the form of a peculiar gait (sometimes called “cerebellar”). When walking, the legs are wide apart and tense, the patient tries not to bend them.

The body is straight, slightly thrown back. When turning, the patient falls over and sometimes even falls. When rearranging the legs, a wide swing amplitude is observed.

Adiadochokinesis appears over time– the patient cannot alternate movements (for example, alternately touch the tip of the nose with his fingers).

Speech function is impaired, handwriting deteriorates, the face acquires mask-like features (due to impaired facial expressions). Such patients are often mistaken for drunks, which is why medical assistance is not provided on time.

Patients complain of pain in the legs and arms, lower back, and neck. Muscle tone is increased, convulsive twitches may appear.

Ptosis, convergent strabismus, and dizziness when trying to focus the gaze often occur. Visual acuity decreases, mental disorders and depression.

Diagnostics

When conducting a full range of examinations, making a diagnosis does not cause difficulties.

Required to be taken functional test, assessment of tendon reflexes, blood and cerebrospinal fluid examination.

Appointed computed tomography and ultrasound of the brain, anamnesis is collected.

It is important to start treatment on time!

Cerebellar ataxia is a serious disorder that requires immediate action; treatment is carried out by a neurologist.

It is most often symptomatic and covers the following areas:

• restorative therapy (prescription of cholinesterase inhibitors, Cerebrolysin, B vitamins);
• physiotherapy, the purpose of which is to prevent various complications (muscle atrophy, contracture), improve gait and coordination, and maintain physical fitness.

Training complex

Appointed gymnastics complex, consisting of exercise therapy exercises.

The goal of the training is to reduce incoordination and strengthen muscles.

At surgical treatment(elimination of cerebellar tumors) one can expect partial or full recovery or stopping the development of the disease.

In this case, drugs aimed at maintaining mitochondrial functions (vitamin E, Riboflavin) play an important role.

If the pathology is a consequence, in mandatory treatment for this infection is prescribed. The doctor prescribes drugs that improve cerebral circulation, nootropics, betahistine.

A special massage helps reduce the severity of symptoms.

The consequences can be the saddest

Complications of ataxia may include:

• tendency to recurrent infections;
• chronic heart failure;
• respiratory failure.

Forecast

It is impossible to completely cure cerebellar ataxia.

The prognosis is rather unfavorable, since the disease tends to progress quickly. The disease significantly impairs the quality of life and leads to numerous organ disorders.

Cerebellar ataxia is very serious illness. At the first symptoms, you must immediately contact a specialist for comprehensive examination.

If the diagnosis is confirmed, timely adoption of measures will significantly alleviate the patient’s condition in the future and slow down the progression of the disease.

Ataxia, or in other words, incoordination or disruption of coordination in the interaction of muscle groups, manifested by a violation of targeted static functions and movements human body. Various types of ataxia are classified.

Ataxia is considered a common pathology, which is characterized by impaired motor skills - while the strength of the limbs is completely preserved or very slightly reduced. But movements become unclear, clumsy, and imbalance occurs when walking or standing.

To implement any necessary movement, the joint activity of many muscles is required. Movement itself is ensured by mechanisms that regulate the choice of one or another muscle group, the duration and strength of each muscle contraction, as well as the sequence of their action in the motor act. In the absence of coordination in the muscles, a violation of the quality of movements, loss of proportionality of movements, and their accuracy develops. Movements become intermittent, unsmooth and clumsy. And the transition between two movements, for example, extension and flexion, becomes very difficult.

Types and symptoms of the disease

There are 5 types of ataxia: locomotor, cortical, labyrinthine, sensory, episodic and intrapsychic. Each is an episodic ataxia characterized by acute episodes of exacerbation.

Cerebellar or locomotor ataxia

Cerebellar disease leads to the development of this type of pathology. While walking, the patient spreads his legs wide and leans forward and backward. Light form diagnosed only on the condition that the patient walks strictly in a straight line with side steps. With eyes closed, coordination problems do not become more pronounced. If the disease affects the medial part of the cerebellum, the patient experiences problems with balance and walking. When the cerebral hemispheres are damaged, the patient's movements become imprecise and tremors may occur.

The main causes of cerebellar ataxia include: abscess in the cerebellum, stroke, viral form encephalitis, drug poisoning.

To the reasons for the formation chronic form Cerebellar ataxia includes: degeneration of the cerebellum due to the development of oncology of the ovaries, lungs, mammary glands, neoplasm in the posterior part of the cranial fossa, hypothyroidism, prolapse of the tonsils in the cerebellum, alcohol poisoning of the cerebellum, poor heredity. The hereditary form of the pathology can occur in an autosomal recessive or autosomal dominant manner.

Cortical ataxia

It manifests itself as a disturbance in a person’s gait—the gait seems to take on a staggering character. With severe damage to the cerebral cortex, paralysis can form, and the patient loses the ability to walk or even stand. In addition, other manifestations of damage to the cerebral cortex develop, such as changes mental state, hallucinations of an olfactory nature, auditory hallucinations, memory impairment for current events and disruption of the visual organs.

Ataxia labyrinthine or vestibular

Develops in the case of pathology of the vestibular nerve or vestibular apparatus during inner ear.

Manifestations of the vestibular type of ataxia include: nausea with vomiting, nystagmus, dizziness and hearing impairment. When turning the eyes or changing posture, the symptoms of the vestibular type of ataxia are more pronounced, while the coordination of the upper limbs does not suffer in any way.

Its development is caused by a disease of the fibers, which contain information about human postures and body position, especially in the horizontal plane.

The sensory form of ataxia can be provoked by the influence of the following factors on the body: pathology spinal cord that damage the fibers ascending to the brain - these are tumor formations of various origins, multiple sclerosis, diseases vascular system, avitaminosis is usually a lack of vitamin B12 in the body.

This is important! Symptoms of sensory ataxia include the following: incoordination when walking in complete darkness, deterioration of reflexes in the tendons, poor balance with eyes closed, and impaired vibration sensitivity detected during examination.

A person with a sensory form of ataxia, thanks to his vision, controls his own steps, but instead of a hard surface he feels cotton wool under his feet. While walking, the patient raises his legs high and lowers them to the ground with great force.

Ataxia intrapsychic

This type of ataxia is a lack of coordination between thinking and a person’s emotions and is most often considered a manifestation of schizophrenia.

How is ataxia diagnosed?

Diagnosis of the disease is based on identifying its form and identifying a person affected by ataxia in the family.

When conducting laboratory examination An abnormal metabolism of amino acids is detected - their concentration is too low, and their excretion in the urine also decreases.

MRI of the brain shows atrophic processes in the brain and spinal cord, in the upper part of the skull. Using electromyography, damage to sensory fibers in peripheral nerves is diagnosed.

This is important! When differentiating ataxia from other pathologies, it is necessary to pay attention to the possibility of changes clinical manifestations ataxia. IN medical practice cases of rudimentary types of ataxia and the development of its transitional types are known, when clinical signs resemble symptoms of multiple sclerosis, etc.

In order to identify hereditary ataxia, it will be necessary to implement indirect or direct research DNA tests. Using molecular genetic methods, ataxia is detected, and then a DNA test is performed to determine the possibility of children inheriting the pathological gene from their parents.

Sometimes a comprehensive examination of DNA tests is required, this requires biomaterial taken from all family members.

Organization of the treatment process

Treatment of the disease is organized by a neurologist and is mainly symptomatic and includes:

• General strengthening treatment - consumption of B vitamins and other remedies.
• Complex physical exercise physical therapy, helping to strengthen muscles and normalize coordination of movements.

In addition to the described treatment, the treatment of ataxia requires correction of immunodeficiency. So, it is necessary to take a course of immunoglobulin. Radiation therapy in this situation is contraindicated, and it is also necessary to prevent excessive exposure to x-rays and prolonged exposure to open sunlight.

This is important! Important role Medicines that restore the functioning of mitochondria, namely riboflavin, succinic acid, vitamin E, can play a role in the healing process.

How is prevention carried out?

If you have a hereditary form of ataxia, you should avoid having children. In addition, it is necessary to abandon the possibility of concluding related marriages.

The prognosis of the described diseases rarely remains favorable. There is a slow development of disorders of the neuropsychic system of the body. More often than not, this negatively affects the patient’s performance.

But with proper organization symptomatic therapy and preventing infectious lesions of the body, poisoning, and injuries, a person can live for many more years.

Ataxia is a neuromuscular motor disorder that is characterized by impaired coordination of movements, as well as loss of balance both at rest and when walking. Inconsistency in the actions of various muscles can arise as a result of damage to certain parts of the brain or vestibular apparatus, which is sometimes due to genetic predisposition. Treatment of ataxia and the prognosis of its development depend on the cause of the disease.

Types of ataxia

In clinical practice there are the following types ataxia:

• Sensitive;
• Vestibular;
• Cortical or frontal;
• Cerebellar.

In sensitive ataxia, the fibers of deep sensitivity, which carry information about the features of the surrounding space and the position of the body in it, are disrupted. The cause may be damage to the posterior columns of the spinal cord, thalamus or spinal nerves, as well as polyneuropathy and vitamin B12 deficiency.

Upon examination, the following symptoms of sensitive ataxia are revealed:

• Dependence of coordination on visual control;
• Violation of vibration and joint-muscular sensitivity;
• Losing balance with eyes closed in Romberg pose;
• Loss or decrease in tendon reflexes;
• Unsteady gait.

A characteristic sign of sensory ataxia is the sensation of walking on carpet or cotton wool. In order to compensate movement disorders, patients constantly look at their feet, and also raise their legs high and bend their legs strongly at the knees and hip joints, and then forcefully lower the entire sole to the floor.

In vestibular ataxia, dysfunction of the vestibular apparatus leads to specific gait disturbances, systemic dizziness, nausea and vomiting. All symptoms intensify with sudden turns of the head and changes in body position. Possible hearing impairment and horizontal nystagmus - involuntary movements of the eyeballs. This type of disease can be caused by brainstem encephalitis, ear diseases, tumors of the brain ventricles and Meniere's syndrome.

Cortical ataxia is caused by dysfunction of the frontal lobe of the brain as a result of dysfunction of the fronto-pontine-cerebellar system. The reason may be due to incorrect cerebral circulation, tumors or abscesses.

Frontal ataxia occurs on the side of the body opposite the affected hemisphere. Instability, bending or falling over begin at turns, and with severe injuries, patients are not able to stand or walk at all. This coordination disorder is also characterized by disturbances in the sense of smell, mental changes and a pronounced grasping reflex.

Features of cerebellar ataxia are loss of fluency of speech, tremors various types, muscle hypotonia and oculomotor dysfunction. The gait also has characteristic features: patients spread their legs wide apart and sway from side to side. In the Romberg position there is extreme instability, often falling backward. A severe lack of coordination of movements occurs during tandem walking, when the heel of one leg is placed against the toe of the other. Cerebellar ataxia can be caused by a wide range of diseases - from vitamin deficiency and intoxication medicines to a malignant tumor.

Hereditary degenerative changes cerebellum cause spinocerebellar ataxia - chronic diseases of a progressive nature, which are of a dominant or recessive type.

The autosomal dominant cerebellar form of the disease is often accompanied by the following symptoms:

• Tremor;
• Hyperreflexia;
• Amyotrophy;
• Ophthalmoplegia;
• Pelvic disorders.

The pathological sign of Pierre Marie's ataxia is cerebellar hypoplasia, less often - atrophy of the inferior olives and pons. The first gait disturbances begin, on average, at 35 years of age. Subsequently, disturbances in facial expressions and speech are added. Mental disorders manifest themselves in the form of depression and decreased intelligence.

Autosomal recessive spinocerebellar ataxia is associated with the following symptoms:

• Areflexia;
• Dysarthria;
• Hypertonicity of muscles;
• Scoliosis;
• Cardiomyopathy;
• Diabetes mellitus.

Friedreich's familial ataxia occurs due to damage to the spinal systems, most often as a result of consanguineous marriage. The main pathological symptom is increasing degeneration of the posterior and lateral columns of the spinal cord. At about 15 years of age, unsteadiness when walking and frequent falls appear. Over time, skeletal changes cause a tendency to frequent joint dislocations and kyphoscoliosis. The heart suffers - the atrial waves are deformed, the heart rate. After any physical exertion, shortness of breath and paroxysmal pain in the heart begin.

Diagnosis and treatment of ataxia

For cerebellar ataxia, the following studies are performed:

• EEG. Reveals reduction of alpha rhythm and diffuse delta and theta activity;
• MRI. Carry out to detect atrophy of the brain stems and spinal cord;
• Electromyography. Shows axonal demyelinating damage to peripheral nerve fibers;
• Laboratory tests. Allows observation of amino acid metabolism disorders;
• DNA test. Installs genetic predisposition to ataxia.

Treatment of ataxia is aimed at eliminating symptoms. It is carried out by a neurologist and includes:

• General restorative therapy - anticholinesterase drugs, cerebrolysin, ATP, B vitamins;
• Exercise therapy complex – strengthens muscles and reduces incoordination.

When treating spinocerebellar ataxia, a course of immunoglobulin may be required to correct immunodeficiency, and any radiation is contraindicated. Sometimes succinic acid, riboflavin, vitamin E and other drugs are prescribed to maintain mitochondrial function.

The prognosis for hereditary ataxia is unfavorable. Working capacity, as a rule, decreases, and mental disorders are progressing.

Video from YouTube on the topic of the article:

IN lately Increasingly, such a phenomenon as the genetic nature of the development of the disease has begun to appear, or in other words, the patient’s inability to influence the development of the disease on initial stage. Ataxia also belongs to similar diseases, but we will look at what ataxia is and what types of this disease are found in this article.

Ataxia is characterized by a violation of human motor skills and is a neuromuscular type of disease. The diagnosis of ataxia is made by a neurologist, since this ailment belongs to the diseases nervous system. During its development, the patient's central nervous system is affected; there may be some stiffness in movements, straining when walking and dependence of movements on visual contact, and impaired coordination of movements.

At the same time, the muscles do not lose their strength, or lose it only slightly.

The reasons for the development of this disease are associated primarily with genetic nature. In addition, there is reason to believe that the formation of such a disease is influenced by a deficiency of vitamin B12 in the body.

In addition, the reasons include:

• inflammatory processes in the body ();
• drug use;
• conversion disorders;
• alcohol abuse;
• the presence of infection in the body or against the background of an infectious disease;
• presence of tumor processes;
• disruptions in the endocrine system.

Many experts believe that disorders of this kind arise not as an independent type of disease, but as a consequence of a previous or existing disease. That is, ataxia is one of the symptoms of some more severe and dangerous disease, which the patient is not yet aware of.

Classification of ataxia and its symptoms

The symptoms of ataxia vary greatly depending on the type of disease. Since when a particular organ is damaged, individual manifestations are observed. This disease has the following subtypes:

1. Cerebellar.
2. Vestibular.
3. Cortical.

Determination of ataxia by gait

In addition to the above subtypes of the disease, there are several more of its varieties, which one way or another can be classified as one of the main types, but have some features that make it possible to distinguish them into a separate group, including:

• cerebellar ataxia of Pierre-Marie;
• Friedreich's familial ataxia ( hereditary ataxia Friedreich);
• telangiectasia ().

There are several more subspecies that will not be discussed in detail within the scope of this article, including:

Optical is a disease that occurs as a result of damage to the posterior parietal cortex of the brain. It is characterized by the inability of a person to touch any object within sight due to inconsistency of hand movements.

Intrapsychic ataxia is part of schizophrenia and is a disorder of the individual’s psyche.

Despite the rich classification of this disease, it has general symptoms, and the first symptoms include:

• violation of movement coordination;
• nausea;
• vomit;
• involuntary muscle twitching;
• change in handwriting;
• slow speech;
• blurred vision;
• changes in mental state;
• presence of hallucinations (auditory, visual);
• memory impairment;
• violation of facial expressions.

Often the symptoms of this disease are similar to those that occur with neurosis, as a result of which many people confuse the first signs of the disease. In any case, if you suspect any deviations in the behavior of a potential patient, there is no need to delay, but rather consult a doctor as soon as possible.

Sensitive ataxia is the most common disease and develops as a result of damage to the posterior columns of the spinal cord, namely the pathways located there.

There are several types (severities) of the disease:

• damage to the upper extremities with loss of coordination of movement;
• damage to the lower extremities with loss of coordination and sensitivity in this area of ​​the body;
• damage to one of the limbs, with loss of coordination and sensitivity;
• damage to all limbs;
• loss of coordination of the movement of the entire body (the case when the brain cannot determine how it is located relative to the earth’s surface, as well as how the arms and legs are located relative to each other).

If this type of disease develops, a person may experience imbalances, since it is often the lower limbs. Walking becomes visually dependent (the lack of visual contact with the area where the foot will be placed makes movement extremely difficult). The patient may feel that walking resembles walking on thick cardboard or cotton wool. The foot is placed on the floor with characteristic pressure on the foot.

Damaged spinal cord trunk

In addition, the patient is unable to maintain balance in a position with his arms and legs spread to the sides.

When testing the patient using the Romberg method, the result is negative.

The Romberg test is a method of determining movement coordination, which is expressed in observing the patient when he is in a position specified by the doctor. The usual Romberg pose is legs out to the sides, arms forward, fingers spread. Difficult pose - Legs stand in one line, with the heel of one leg touching the toe of the other, arms extended forward, fingers spread. The average time spent in this position with eyes closed is from 30 to 50 seconds without loss of coordination.

The more severe the illness, the worse the ability to walk. At the most severe stages this opportunity may be completely lost.

Cerebellar

Cerebellar ataxia (sometimes called truncal ataxia) belongs to the second large subtype of this disease. The main difference between the disease and the sensitive type is that when the cerebellum is damaged, the symptoms spread to all limbs and the body as a whole, while with the sensitive type of the disease only one limb can be affected.

Main symptoms of this disease the following:

• change in gait, inability to stand straight;
• imbalance;
• tremor of the limbs;
• tense pronunciation of words with their noticeable separation;
• eye twitching.

The reasons for the development of this disease are:

• poisoning medications(abuse or excessive long-term use the same medicine)
• cerebellar stroke (this phenomenon is dangerous not only with the risk of ataxia, but also with the risk of death);
• infectious diseases (encephalitis, chickenpox, etc.);
• cerebral palsy;
• traumatic brain injuries.

The patient and the people around him will definitely notice that something is wrong with the patient. For example, the patient’s gait will resemble a pendulum. He will walk on straight legs, swaying from side to side. When standing still with legs wide apart, if you sharply push one of the legs, the patient will fall and not even notice it.

During turns while walking, the patient may even fall.

Gradually, the patient ceases to understand in what order it is necessary to rearrange his legs and move his arms when walking. A kind of mask freezes on the face, which is why the patient looks like a drunk person. Speech slows down, handwriting deteriorates, strabismus may develop and visual acuity may deteriorate. Mental disorders and depression gradually develop.

In children, this disease can develop after 3 years, but the main age ranges from one to three years.

Cerebellar ataxia of Pierre-Marie

This disease is one of the subtypes of cerebellar ataxia and is a hereditary disease.
The likelihood of the disease among the patient's first-degree relatives is quite high. The disease is progressive and cannot be diagnosed until early stages development is difficult.

The first manifestations of the disease are visualized by others at the age of 35–40 years. The symptoms are the same as with ordinary cerebellar ataxia.

The main difference is the cause of development - cerebellar hypoplasia.

Vestibular

This type of disease is a direct continuation of the underlying disease. That is, vestibular ataxia does not occur independently, but only as an accompanying symptom.

The main manifestations of this disease are as follows:

• impaired coordination of movement and rest (standing or sitting);
• nausea;
• vomit;
• nystagmus;

Nystagmus - involuntary eye movement (twitching)

• sleep disturbance (dizziness may bother the patient when lying down);
• dizziness;
• autonomic disorders (pallor or redness, tachycardia, pulse instability).

The main reasons for the development of the vestibular type of disease are the following:

• damage to hair cells, resulting inflammatory processes in the inner ear (otitis, trauma, aerootitis, tumor, cholesteatoma of the ear)

Hair cells are auditory receptors

Cholesteatoma is a tumor neoplasm containing capsule-shaped growths

• damage to the vestibular nerve (tumor, infectious disease, toxic poisoning)
• damage to the vestibular nuclei in the medulla oblongata (tumor, encephalitis, arachnoiditis, multiple sclerosis, atherosclerosis)
• traumatic brain injury

The main difference between vestibular disease and others is the dependence of symptoms on turning the head or body. Typically, these actions cause maximum inconvenience to the patient, for this reason he tries to perform them smoothly and without sudden movements; in addition, with his eyes closed, he feels a greater lack of coordination of movement.

Since hair cells are usually affected on one side of the body, the patient will be “skewed” to this side.

Cortical

Cortical or frontal ataxia is one of the varieties of the disease, which in many symptoms is similar to cerebellar ataxia, but also has its own characteristics.

Some scientific facts about illness

The main symptoms of the progression of this disease, in addition to the general ones, are the following:

• development of the grasping reflex;
• mental change;
• impaired sense of smell;
• falling back when walking;
• instability.

A patient with a cortical type of illness moves along one line with a constant deviation of the body backwards.

The cause of the disease is damage to the frontal lobe of the brain as a result of:

• tumors;
• abscesses;
• circulatory disorders;
• stroke.

Friedreich's ataxia

Friedreich's ataxia is a hereditary disease that has almost all the symptoms characteristic of ataxia. The main difference between this disease and the others is the route of its transmission - heredity.

Friedreich's ataxia can be of both cerebellar and sensitive types. The disease develops from 10 to 20 years, there is a possibility of later manifestation, but in rare cases.

The main symptoms are as follows:

• unsteady gait;
• stumbling and falling when walking;
• uncertainty when moving;
• hand tremors;
• change in handwriting;
• hearing loss;
• deterioration and slowing of speech;
• loss of ability to care for oneself;
• development of dementia;
• disorders of the nervous system (arrhythmia, formation of “Friedreich’s foot”, disorders in the endocrine system).

This is what Friedreich's foot looks like

The causes of the disease are mutations that lead to the accumulation of toxic substances in the body and heavy metals. This, in turn, leads to damage to neurons, cells of the pancreas and heart, as well as the muscles of the eye, etc. All these processes, one way or another, lead to the development of Friedreich's ataxia.

The dynamic nature of cerebellar ataxia

In modern neurology, two types of ataxia are distinguished according to the nature of its manifestation - dynamic and static

As a rule, most often you can come across such a thing as dynamic cerebellar ataxia, which manifests itself, as it became clear, with damage to the cerebellum.

Its main difference from the static one is that all violations, one way or another, are associated with the movement of the patient.

It is believed that dynamic type The disease is the most severe form of the disease, since the patient is not able to move independently.

Static nature of cerebellar ataxia

As for the static type of this disease, or as it is sometimes called static locomotor disease. In this case, the severity of the disease is lower than in the dynamic case. The basis of the symptoms are manifestations of imbalance when the patient’s body is positioned at rest (standing, sitting and even lying down).

Diagnosis of ataxia

In order to correctly diagnose and differentiate different types disease applies comprehensive diagnostics, which includes several stages.

So, at the very first stage, the doctor needs to determine what type of disease the disease belongs to, based on the type of course. For this purpose, a special neurological classification is used:

1. Spicy.
2. Subacute.
3. Progressive.
4. Episodic.

Depending on the underlying disease and the nature of the symptoms, one can draw conclusions about one or another type of illness. There may be several options, so the doctor never relies only on the results of any one study.

After the type of course is established, the doctor begins to deal with the type of illness itself, from the above classification. As a rule, complex neurological tests are used for this:

• Romberg pose;
• finger tests;
• knee-heel tests;
• hand lowering test;
• reverse shock symptom;
• pay attention to the presence of Burdzinski syndrome.

In addition to studying the patient's medical history and conducting various tests, they prescribe instrumental studies. Including:

• magnetic resonance imaging;
• general and clinical analysis blood;
• computed tomography;
• Ultrasound of the brain;
• cerebrospinal fluid analysis.

Depending on the severity of the diagnosis, additional tests may be prescribed.

Treatment and prognosis of ataxia

To treat such a disease, it is important not to delay, as it progresses and can develop into a more severe form.
Since the main cause of the disease is concomitant illness, ataxia is treated symptomatically, and the main therapy is already directed to the disease that caused this symptom.

In most cases, it is not worth saying that the disease is curable; perhaps, it can only reduce the symptoms and make the person’s future life easier. However, this does not mean that it is impossible to completely get rid of it. How to cure an unpleasant illness forever?

First of all, by complete cure from the underlying disease. However, if the development of the disease is advanced, the chances of getting rid of ataxia forever are slim.

• therapeutic massage;
• medicinal physical culture(physical therapy);
• application vitamin complex(vitamin E, coenzine Q10);
• use of riboflavin and succinic acid.

The prognosis is highly dependent on the severity of the disease. At severe forms it is possible to limit the patient’s work activity in case favorable outcome there is a high probability of patients surviving to a ripe old age. For mild forms and exceptions re-development infectious diseases, it is possible to get rid of the disease completely.

Treatment of this disease folk remedies, and even without the supervision of a specialist, this is an extremely unreasonable decision and our editors are strongly against such decisions.

Exercise therapy

Exercises for ataxia play an important role in the treatment of the disease, which can be divided into several blocks:

1. General strengthening (turns, swings of limbs).
2. Developing accuracy (the main condition is to hit the indicated plane with your hand or foot, gradually the complexity of the tasks increases, loads are added).
3. Developing coherence in the joints (consists in setting tasks for lifting or moving various objects, and joints should be involved in this work; it is gradually possible to use weights during these exercises).
4. To stimulate ballistics (throwing, pushing or simulating such activity, the throwing distance increases each time).
5. To improve balance (exercises to improve balance with the help of additional movements, standing, sitting and walking, you can gradually introduce the use of parallel bars for these purposes).
6. Training the eye muscles (Fixation with the eyes of a certain point, which is followed during head tilts or turns, as well as in movement).
7. To develop muscle-joint sense (guessing an object by sensations with eyes closed).

There is an opinion that it is possible to use such a device as a balancer for children, however, its use can only be prescribed by a doctor; in no case do you self-medicate, as you can injure the baby.

Prevention

Prevention is understood as a set of measures that prevent further spread of the disease and prevent its occurrence in healthy people.

• exclusion of consanguineous marriages;
• exclusion of pregnancy in families with ataxia;
• timely treatment of infectious diseases;
• preventing the accumulation of toxic and heavy metals in the body;
• conducting healthy image life;
• compliance with sleep and nutrition;
• timely contact a specialist for help.

So, ataxia is serious concomitant disease which requires mandatory medical intervention. The longer a patient delays contacting a specialist, the less likely he is to fully recover from such an illness; moreover, the underlying disease may even kill him. Take care of yourself, do not self-medicate and get treatment from the right doctors!