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Ataxia (Diagnosis (History (DH Current meds, allergies, FH Neurological…
Ataxia
Diagnosis
Examination
CN exam
Cerebellar: nystagmus, dysarthria
Limbs
Cerebellar:
gait ataxia, intention tremor,
disdiadokinesis, hypotonia, hyporeflexia
Seonsory:
reduced joint position sense, pseudoathetosis, Romberg +ve (lost position sense with eyes closed)
Investigations
Bloods
FBC, CRP, U+E, LFT,
vitamins, Cu
Infection screen (HIV, CJD, measles)
Genetic screen (SCA, FA, AT)
Imaging
CT/MRI: structural lesions, stroke, SOLs
Bedside
Obs (iinfection)
ECG (arrhythmia)
History
DH
Current meds, allergies
FH
Neurological disorders
PMH
Known medical conditions
SH
Occupation, living arrangements,
alcohol, drugs, diet
PC/HPC
Clumsy gait, poor coordination,
slurred speech, blurred vision
Pathophysiology
Central
Cerebellar
disease
Spinal/
peripheral
Sensory
ataxia
Aetiology
Cerebellar
Vascular
AVM
Stroke
Infection
Measles, varicella, HIV, CJD
Miller FIsher (variant GBS)
Subacute sclerosing
panencephalitis
Trauma
Head trauma
Autoimmune
MS
Metabolic
B1 (thiamine) deficiency
Vit E deficiency
Coeliac disease
Neoplastic
Paraneoplastic syndrome
Primary brain
Mets
Congenital/genetic
Wilson's disease
Spinocerebellar ataxia (SCA, FA, AT etc.)
Mitochondrial disease
Arnold Chiari malformation
Drugs
Alcohol
Phenytoin, carbamazepine, lamotrigine
Lithium
Degenerative
MSA
Spinal/
peripheral
Autoimmune
Sjogren's syndrome
MS (spinal cord)
Degenerative
Cervical spondylosis
Infection
GBS, CIDP
Metabolic
B12 deficiency
Cu deficiency
Neoplastic
Paraneoplastic syndrome
Clinical
presentation
Cerebellar
Ataxic gait
Slurred speech
Poor coordination
Sensory
ataxia
Deterioration of coordination
tests when eyes closed
Definition
Neurological disorder of
incoordination of body
movements
Management
Per cause