Ataxia

Ataxia is derived from a Greek word meaning ‘lack of order’ and can be defined as impairment of coordination in the absence of significant muscle weakness. Patients complain of poor balance when walking and sitting, difficulties with accurate hand movements, tremor and slurred speech. In many cases, the presence of ataxia indicates pathology in the cerebellum and/or its brainstem connections, or an impairment of sensory information. Although the differential diagnosis of ataxia is complex, a careful history and examination can reduce the number of possible causes. This article discusses the principal features, investigation and management of ataxia caused by cerebellar disease and, to a lesser extent, sensory neuropathies in which ataxia is a prominent feature.