Ataxia Evaluation

Ataxia is difficult to identify. It can be inherited, acquired, or may arise from undetermined reasons. It can also result from a number of other disorders.

Causes

Causes of ataxia can include:

  • Diseases of the cerebellum and its connection to other parts of the brain and spinal cord. The cerebellum serves as the brain’s balance and coordination center, integrating information from different parts of the brain and allowing the precise execution of movement during simple tasks such as walking, reaching for an object, writing, or speaking.
  • Alcoholism. When people are inebriated, they become “ataxic” until they sober up – their speech is slurred, they’re not able to walk a straight line, and their movements are uncoordinated. With chronic alcoholism, the cerebellum (like the liver and other organs) may suffer irreversible damage, and permanent ataxia can result.
  • Sudden onset of ataxia can also be caused by certain medical and neurological conditions, including:
    • Head trauma
    • Stroke
    • Brain hemorrhage
    • Brain tumor
    • Exposure to certain drugs or toxins (alcohol, some drugs or medications)
    • Problems with the liver, kidney, or thyroid
    • Vitamin deficiency (especially vitamin E or vitamin B12)
    • Sensitivity to gluten (wheat, rye, and barley)
    • Diabetes
    • Multiple sclerosis

Ataxia can also result from other conditions, including cancers, infections, and immune-mediated disorders; genetic diseases; and neurodegenerative disorders that affect the cerebellum (such as multiple system atrophy). Approximately 30-40 percent of cerebellar ataxias don’t have an identifiable cause, even after extensive testing.

Diagnosing Ataxia

Diagnosis of ataxia is based on a person's medical and family history, along with a complete neurological examination to determine if there are signs of cerebellar disease.

During the examination, we’ll complete an eye exam to check for jerky eye movements or eyes that overshoot their target. People with ataxia are unable to walk a straight line, so your movements and walking will be tested for coordination.

We’ll also check for dysmetria or your inability to correctly judge distance. We may test for dysmetria by asking you to point to your nose, and then to the neurologist's finger. If you reach too far or not far enough, dysmetria is present.

Upon completion of your neurological exam, we may use any of the following tests to determine the cause of your ataxia: 

  • Brain and spinal cord MRI (with or without contrast)
  • Blood tests
  • Full-body CT scan to look for cancers elsewhere that can indirectly affect the cerebellum
  • Spinal tap to look for inflammation or infection of the cerebellum
  • Nerve conduction studies and electromyography (EMG) to look for neuropathy
  • Evaluations by sleep, pulmonary, urology, and ENT specialists
  • Dopamine transporter scan, an imaging technology that uses small amounts of a radioactive drug to help determine how much dopamine is available in a person's brain
  • Autonomic studies
  • Genetic testing

After diagnosis, we’ll work with you to develop a treatment plan that is individualized based on your specific needs.

Request an Appointment

To schedule an appointment with an ataxia expert at UT Southwestern’s facilities in Dallas, or to learn more about our services, request an appointment or call 214-645-8300.