Vestibular ataxia treatment. Vestibular ataxia

Vestibular ataxia

Vestibular ataxia - impairments in motor coordination and ability to maintain posture associated with the lesion vestibular apparatus at any level. Vestibular ataxia manifests itself as unsteadiness in standing and sitting positions, as well as when walking. It is accompanied by systemic dizziness and nystagmus; Nausea and vomiting, autonomic disorders and symptoms characteristic of the pathological process that caused the development of vestibular ataxia may be observed. Diagnosis of the latter is main goal examination of patients with vestibular ataxia. Treatment of vestibular ataxia is symptomatic. The main therapy should be aimed at the causative disease.

Signs of vestibular ataxia

As a rule, it manifests itself as static and dynamic coordination disorders. The severity of vestibular ataxia increases with a certain position of the head and the entire body, and when turning the eyes. Patients avoid sudden head movements and carefully change body position. When the eyes are closed, coordination disturbances are somewhat intensified. Muscle-articular sensation disorders are not determined.

Damage to the vestibular analyzer is characterized by staggering when walking with a deviation to the affected side. If the patient is asked to go with eyes closed several steps in a straight line forward and backward, then the trajectory of its movement constantly deviates from the original direction and resembles a star pattern (“star test”).

Vestibular ataxia is combined with other vestibular disorders. As a rule, there is dizziness of a systemic nature: surrounding objects rotate in a certain direction, especially in certain positions of the head and the whole body. Against the background of dizziness, nausea, vomiting, and blackouts may occur. Nystagmus is noted, often horizontal, directed when the vestibular apparatus is irritated in the direction of irritation, and when it is damaged - in the opposite direction.

Treatment

Treatment should be aimed at the cause of ataxia.

1. Surgery brain or cerebellum:

• tumor removal;
• removal of hemorrhage;
• removal of the abscess, antibacterial therapy;
• decrease in pressure in the back cranial fossa with Arnold-Chiari malformation (descent of part of the cerebellum into the foramen magnum of the skull, leading to compression of the brain stem);
• creating an outflow for cerebrospinal fluid (cerebrospinal fluid that provides nutrition and metabolism to the brain) with hydrocephalus (excessive accumulation of cerebrospinal fluid in the ventricular system of the brain).

2. Normalization of arterial (blood) pressure and drugs that improve cerebral blood flow and metabolism (angioprotectors, nootropics) for cerebral circulatory disorders.

3. Antibiotic therapy for infectious lesions of the brain or inner ear.

4. Hormonal drugs(steroids) and plasmapheresis (removal of blood plasma while preserving blood cells) for demyelinating diseases (associated with the breakdown of myelin, the main protein of the sheaths of nerve fibers).

5. Treatment of poisoning (administration of solutions, vitamins B, C, A).
6. Administration of vitamin B12 in case of deficiency.

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 stroke, multiple sclerosis, brain tumor, head injury, or excessive alcohol consumption.

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 the assimilation of sensory perception, coordination and motor control.

Cerebellar ataxia provokes neurological problems such as:

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 gives 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 start 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.

Nature has endowed the human body with the ability to regulate its own body position, restore coordination in space, and stability when walking and sitting. In cases where these functions are impaired, the symptom is called “vestibular ataxia”. It may occur when various diseases neurological in nature, but is not an independent disease. Therefore, treatment is prescribed based on the nature of the underlying pathology.

The functional chain that ensures the vestibular constancy of the body in space is quite complex. Necessary tone skeletal muscles, as well as corresponding reflex adjustments of balance appear as a signal arrives from the central nervous system(from the cerebellum, reticular formation, cerebral cortex and other structures), depending on the characteristics of the innervation of each organ.

Also involved are the oculomotor nuclei, autonomic ganglia and various chains of neurons. In order for the necessary impulse to be generated, information from the vestibular receptors is needed. They are hair cells located in special place inner ear. They are so sensitive that they react to every, even slightly visually noticeable, change in body position.

The signal from the vestibular receptors enters the vestibular nerve, which transmits the impulse to the coordinating structures of the brain.

When this chain is disrupted, changes in gait, dizziness, nausea and vomiting, and symptoms of disorders in the autonomic nervous system may occur. With vestibular ataxia, nystagmus and loss of balance are common, and the person becomes unable to maintain his posture and regulate his coordination of movements.

What violations will lead to this condition?

All the links in the chain of physiological innervation described above can be damaged as a result of various risk factors. The vestibular apparatus ensures full functioning only with the complete anatomical health of each “participant in the process of nerve impulse transmission.”

The most important and dangerous is damage to hair cells. This can be observed, for example, during inflammatory processes in inner ear. Causes may include: injuries entered by the blood or lymph flow infectious agents, complicated otitis media of the middle ear and spread of infection through the internal canals, tumor processes in the ear, exposure chemical substances, electrical injuries, blood supply disorders, radiation exposure.

As a result of such processes, hair cells may partially or completely lose their viability. Being the initial stage of vestibular ataxia, this condition can lead to a complete loss of regulation of body position in space.

The second participant in the process of transmitting nerve impulses from the vestibular apparatus to the muscular skeleton and sensory organs is the corresponding nerve.

The reasons causing its defeat may be:

Violation of the conductive function of the nerve interrupts the transmitted “signal” and blocks the necessary actions - another option for the development of the symptom “vestibular ataxia”.

Vestibular ataxia can also develop as a result of pathological processes that arise in the involved brain structures. The main ones are:

• compression medulla oblongata as a result of anomalies, injuries, the occurrence of foci of infection;
• hypoxic condition in cerebrovascular accidents;
• anatomical anomalies and developmental defects;
• tumor processes.

Dangerous disorders in the form of ischemic or hemorrhagic strokes, syndrome vertebral artery, hypertonic disease, various types of aneurysms. Vestibular ataxia has been described against the background of atherosclerotic plaques on the inner wall of the vascular trunks, as well as deterioration rheological properties blood.

We cannot exclude the possibility negative impact traumatic factors, especially if the nuclei and roots of the vestibular nerve are involved.

About clinical manifestations

Vestibular ataxia can be conditionally classified into dynamic (during movement) and static (in a standing position). Almost always it depends on the rotation of parts of the body and intensifies depending on their amplitude. A patient with this symptom finds it difficult to make any turns, trying to reduce his pain with smooth movement.

If you ask a patient with vestibular ataxia to close his eyes, his condition will worsen as he loses “visual control” of his coordinating movements.

Since the device providing this function of the body, is bilateral (symmetrical); with unilateral damage, vestibular ataxia can be observed on one side of the body. This looks like a distortion of the gait in one direction, a deviation of the body towards the side on which the pathology arose.

This symptom can be differentiated by asking the patient to take the Romberg position. The second option is to close your eyes and take a few steps. In this case, symmetrical movements of the body will not work. Additionally, a person diagnosed with vestibular ataxia will feel as if everything around them is spinning, including themselves.

Another differential symptom is dizziness, and it can be noted even in a lying position. The connections that exist between the vestibular and visceral structures contribute to the development of such manifestations vegetative functions, such as facial redness, tachycardia, sweating, pulse instability.

What symptoms appear in the later stages?

If treatment is not started in a timely manner primary signs vestibular ataxia (poor coordination of movements, unclear speech, problems with pronunciation of words, dizziness, nausea, vomiting and others) can progress to the next stage.

These are difficulties in eating (problems with swallowing), incipient choking, unreasonable cough, trembling hands, nystagmus, cold feet, decreased vision and hearing, depression, pronounced erratic eye movements. There are often cases when a patient needs a special wheelchair to move around.

How is diagnosis carried out?

First diagnostic criterion Vestibular ataxia is determined by a correctly collected medical history. In combination with the results of the patient’s examination, he will give the doctor a primary diagnosis, confirmation of which is made after instrumental examinations.

Modern diagnostic procedures are: rheoencephalography, echography, electroencephalography, CT scan, x-ray.

If there is any suspicion of vascular pathology as a cause of vestibular ataxia, it is advisable to conduct angiography of cerebral vessels. Special examinations are vestibulometry, stabilography, video-oculography. If vestibular ataxia is accompanied by changes in auditory function, threshold audiometry is used.

About treatment

Vestibular ataxia is not a completely curable pathology. The result of the therapy used depends on individual characteristics organism, it can occur spontaneously in the form of adaptation to the changes that have occurred. Parallel symptoms of vestibular ataxia (depressive state, psychological difficulties) can be corrected using special regimens.

Speech therapy and vocational adaptation are popular. The resulting curvatures of the spine require orthopedic intervention, and the need to restore mobility can be met with the help of physiotherapeutic procedures. Full recovery from vestibular ataxia requires vitamin therapy and a special diet.

Medications are used to relieve muscle spasms and stimulate immune system, prevention of uncontrolled movements eyeballs. It may be necessary to cope with dizziness

Is there prevention?

Vestibular ataxia is a condition in which preventive actions boil down to:

• healthy lifestyle;
• proper nutritious nutrition;
• absence of stressful situations;
• timely treatment somatic pathologies and chronic diseases;
• correct tactics for treating infectious diseases;
• absence of bad habits;
• compliance with sleep and wakefulness patterns, distribution of physical and mental stress.

The interaction of the sense organs, vestibular apparatus, vision and brain structures ensures the full interaction of the human body with external environment. Primary or secondary disturbances in the statokinetic system lead to disorientation in space, loss of balance, visual and hearing disorders. Timely appeal behind medical care will help you avoid dire consequences and receive decompensatory medical prescriptions. They should be started immediately, strictly observing the sequence of stages and the regularity of the load.

How often we walk, perform many actions and don’t even think about how we manage to reproduce these movements with such ease and accuracy. It's all about very complex mechanism, which involves various parts of the central nervous system. Most people do not think that there may be any problems or difficulties with the usual maintenance of balance. However, there are a number of diseases that make it difficult to walk straight, stand, or even fully perform standard finger movements. In some patients with these symptoms, doctors diagnose ataxia.

What is ataxia in adults, pregnant women and children

Ataxia is a lack of coordination of movements. The name of the disease comes from Greek word ataxia - disorder. Patients with this pathology may indeed experience chaotic movements both when walking and when trying to move their fingers, etc. The person begins to complain about the inability to maintain balance and the appearance of awkwardness and inaccuracy while performing any actions. Ataxia can develop at any age, including in young children. In pregnant women, the severity of the disease in some cases may increase, and then it is necessary to additional examinations and more careful monitoring of the heart and respiratory system.

Coordination is a very delicate process that depends on the coordinated work of certain parts of the central nervous system: the cerebellum, the cortex of the temporal and frontal lobes, the vestibular apparatus and conductors of deep muscle sensitivity. If at least one link of this chain is damaged, a person experiences various disturbances in the coordination of movements of body parts.

Patients with ataxia have poor coordination of movements and sometimes find it difficult to maintain their body in a standing position.

In people with ataxia, there is a discrepancy in the actions of different muscles, which leads to the impossibility of full coordination. This causes many problems in everyday life, sometimes it becomes almost impossible to go outside and generally exist independently. Sometimes even strength in the upper and lower extremities decreases.

Video about coordination, ataxia and methods of its treatment

Classification of ataxias

Currently, there are several types of ataxia. They differ in causes and symptoms:

1. Sensitive (posterior columnar) ataxia appears with various disorders in the conductors of deep muscle sensitivity.
2. Cerebellar ataxia is the most common. It can develop due to various disorders, including genetic ones that are inherited. Cerebellar ataxia Pierre-Marie, benign ataxia Westphal-Leiden, ataxia-telangiectasia (Louis-Bar syndrome) are distinguished.
3. Vestibular ataxia begins due to damage to one of the departments of the apparatus of the same name.
4. Cortical, or frontal, ataxia develops with disorders in the temporal and frontal cortex of the brain.
5. Friedreich's familial ataxia progresses due to mixed cerebellar-sensory lesions.
6. Spinocerebellar ataxia is a hereditary disease in which multiple degenerative processes occur in the cerebellum, cortex, white matter and many other parts of the brain.
7. Hysterical (psychogenic) ataxia manifests itself in pretentious and in unusual ways walking. This separate species, which is not associated with actual damage to brain structures.

There is also a classification according to the types of coordination disorders. If a person has difficulty maintaining balance while standing, they speak of static ataxia. When problems occur during movements and walking, dynamic ataxia is diagnosed.

Symptoms and causes of ataxia

Each type of ataxia must be considered separately, since the types of the disease differ greatly in the causes of its occurrence and the symptoms shown. Sometimes doctors need to conduct many examinations and examinations in order to accurately establish the localization of pathological processes and determine the type of ataxia.

Sensitive (posterior columnar) ataxia

This type of ataxia appears due to disturbances in the posterior columns of the spinal cord and nerves, cortex in parietal region brain. The conductors of deep muscle sensitivity are affected. Patients cease to fully feel and control muscles and joints, and the sense of mass, pressure and position of the body in space is also impaired. It is worth understanding that sensory ataxia is not specific diseases and it manifests itself as one of the symptoms in all kinds of neurological diseases. The cause of this type of disorder may be benign or malignant neoplasms in the spinal cord, neurosyphilis, spinal injuries and fractures, multiple sclerosis. In some cases, sensory ataxia may occur after unsuccessful brain surgery.

The symptoms in patients are very obvious; disturbances in coordination of movements are visible to the naked eye. A person cannot walk normally, he bends his knees too much or, conversely, weakly, and sometimes even tries to walk on straight legs. Since it becomes difficult for the patient to feel himself in space, he begins to strongly knock his heels on the floor when moving, because he is not aware of the real distance to the surface and his own body weight. Doctors call this gait “stamping.” The patients themselves say that they feel as if they are walking on a soft surface and falling through. To begin to control their gait, they have to constantly look at their feet. As soon as you look away, coordination disappears again. It also becomes difficult to take care of yourself at home, and fine motor skills are impaired. When the patient is at rest, his fingers may move involuntarily and sharply. In some cases, violations may affect only the top or only lower limbs.

Cerebellar ataxia is one of the most common forms of coordination disorder. When a person sits or walks, he or she is found to lean towards the affected area of ​​the cerebellum. If the patient falls to any side and even backwards, then this is a characteristic symptom of a disorder in the cerebellar vermis. People complain about the inability to maintain a normal gait, because they stop assessing the correctness of their movements and feel how they move their legs. Patients feel very insecure, stagger, and place their feet wide apart. Visual control practically does not help maintain balance. Muscle tone may decrease significantly, especially on the side where the lesions occurred in the cerebellum. In addition to gait disturbances, deviations in the pronunciation of words are also noted. Patients draw out syllables and pronounce phrases slowly. Also a characteristic symptom is sweeping and uneven handwriting.

Cerebellar ataxia can be a consequence of brain injury and a consequence of surgery. This disorder is also very common when various types encephalitis, multiple sclerosis, neoplasms in the brain, with damage to blood vessels in the spinal cord and cerebellum. The causes may also be alcoholism and drug addiction, in which the entire human body is subjected to serious toxic poisoning.

Cerebellar ataxia is classified according to the speed of its flow. The disease can be acute (symptoms appear in one day), subacute (symptoms increase over several weeks), chronic (ever progressive) and episodic.

Cerebellar ataxia of Pierre-Marie

This type of ataxia is hereditary. It flows into chronic form and is constantly progressing. Usually the disease makes itself felt around the age of twenty, most often after thirty. Patients experience degenerative processes in the cerebellum and its conducting tissues. This disease is transmitted in an autosomal dominant manner. This means that children of both sexes can get sick if the defective gene is passed on from at least one of the parents.

Often, the appearance of Pierre-Marie's ataxia can be triggered by head trauma, certain infectious diseases (typhoid and typhus, dysentery, brucellosis, etc.) and even pregnancy. The symptoms of this pathology are very similar to ordinary cerebellar ataxia; they begin with slight disturbances in gait and strange shooting pains in the lower back and lower extremities. Subsequently, hand trembling joins, facial muscles begin to contract involuntarily.

A characteristic feature are visual impairment due to degenerative processes in optic nerve. Some people begin to gradually develop prolapse upper eyelid, the visual field decreases. Statistical ataxia is also recorded in patients; depressive states and even a decrease in intelligence.

Cerebellar ataxia acute Leiden-Westphal

This type of ataxia occurs most often in young children after suffering infectious diseases. This complication appears very quickly, and the course of the disease occurs in acute or subacute form. About two weeks after suffering from influenza, typhus, and some other diseases, the child begins to experience the first signs of damage to the cerebellar structures. Children lose control of coordination when standing and walking. The movements become very sweeping and disproportionate, but babies have difficulty feeling these changes. Also common symptom is asynergy, in which it becomes impossible to correctly combine muscle movements.

Ataxia-telangiectasia (Louis-Bar syndrome)

This type of cerebellar ataxia is also hereditary. This disease manifests itself very early, with the first signs appearing in young children around the age of several months. In medicine, Louis-Bar syndrome is classified as a special subtype - phakomatosis - due to genetically determined degenerative processes in the nervous system and disorders skin. It is transmitted in an autosomal recessive manner, can be inherited from any parent and manifests itself in children of both sexes. For the disease to occur, mom and dad must be carriers of the defective gene. Fortunately, this is extremely rare and ataxia-telangiectasia occurs in only one child out of 40 thousand births.

Degenerative processes in the cerebellum and some other parts of the brain are combined with reduced immunity due to a lack of immunoglobulins A and E. Because of this, children often suffer from all kinds of infectious diseases and suffer from oncological diseases which usually strike lymphatic system. A characteristic symptom in combination with ataxia is the appearance of spider veins (telangiectasia) different sizes all over the body and even on the whites of the eyes.

Vestibular ataxia

The vestibular apparatus is responsible for human coordination and proper movement. Patients feel as if they are long time circled in one place around its axis. They stagger, do not maintain their body position well, their eyes twitch involuntarily and quickly, they become dizzy, and may feel nauseous. A characteristic feature is an increase in symptoms when turning the head, eyes and body. It is because of this that patients try to move as carefully, carefully and slowly as possible in order to have time to control changes in the body in space.

This type of ataxia can begin due to damage to any part of the vestibular apparatus, but most often, disorders of the hair cells are detected in the inner ear. These injuries can occur due to otitis media, ear trauma, or tumor formations. The vestibular nerve is also sometimes affected due to various infections and even the use of medications.

Cortical or frontal ataxia

Cortical ataxia begins due to lesions in the frontal lobe of the brain. The symptoms are similar to disorders of the cerebellar structures. Some, in addition to uncertainty when walking, experience astasia, in which it is impossible to stand, and abasia, when the patient is unable to walk. Visual control does not help maintain motor coordination. Also identified characteristic symptoms, indicating damage to the cortex in frontal lobes: mental changes, impaired sense of smell, decreased grasping reflex. The cause of this type of ataxia is various inflammatory diseases, encephalitis, brain tumors and circulatory disorders.

Spinocerebellar ataxias

There is a whole complex of spinocerebellar ataxias, which are hereditary diseases. Currently, doctors identify more than twenty different species. All of them are transmitted in an autosomal dominant manner, and with each new generation the symptoms and severity of the disease become more pronounced, especially if the defective gene was inherited from the father.

Despite the differences in different types of spinocerebellar ataxias, they all have a similar mechanism of development. Due to an increase in the amount of glutamine in proteins involved in the metabolism of nervous tissue, their structure changes, which leads to disease. The age of first manifestations of the disease varies depending on the type of disease. In some cases, the first symptoms are detected in the preschool years, and in others - after thirty years. Manifestations of ataxia are standard: loss of coordination, deterioration of vision, handwriting, deviations in work internal organs.

Psychogenic or hysterical ataxia

This type is very different from others; it is not associated with organic disorders in the central nervous system. Because of mental disorders a person’s gait, facial expressions, and pronunciation of words change. The patient begins to perceive himself worse in space. Very often, hysterical ataxia develops in patients with schizophrenia.

Familial Friedreich's ataxia

This type of ataxia is hereditary and is transmitted in an autosomal recessive manner, very often in consanguineous marriages. Due to a mutation in the gene that encodes the protein frataxin, which transports iron from mitochondria, permanent degenerative damage to the nervous system occurs. The lesion in Friedreich's ataxia is of a mixed nature, cerebellar-sensitive; disturbances in the columns of the spinal cord gradually increase, especially in the Gaulle bundles. The first signs of the disease usually begin to appear before the age of twenty-five.

Friedreich's ataxia can occur in both boys and girls. Distinctive feature is the fact that this disease has not been identified in any person of the Negroid race.

The symptoms are similar to other cerebellar ataxias: patients move unsteadily, stagger from side to side. As the disease progresses, it becomes difficult to coordinate the work of the upper and lower extremities, facial muscles and chest. Many people suffering from pathology develop hearing loss. Over time, the following disorders develop:

• interruptions in the functioning of the heart appear rapid pulse, shortness of breath;
• kyphoscoliosis, in which deformation of the spine occurs in different planes;
• violation of the structure of the foot, it changes its shape, becomes curved;
• diabetes;
• decreased production of sex hormones;
• atrophy of the upper and lower extremities;
• dementia;
• infantilism.

This type of disease is one of the most common types of ataxia. Occurs in approximately 3–7 people out of one hundred thousand people.

Video about Friedreich's familial ataxia

Diagnosis and differential diagnosis

At the first signs of ataxia, you should consult a neurologist. For further consultation, he can refer you to a geneticist, oncologist, traumatologist, endocrinologist, otolaryngologist and various other specialists.

To study disorders of the vestibular apparatus, the following procedures may be prescribed:

• stabilography, in which the patient’s stability is analyzed using an oscilloscope;
• vestibulometry - a set of techniques that allows you to evaluate the functioning of the vestibular apparatus;
• Electronystagmography, which records eye movements to determine the cause of dizziness and identify disorders of the inner ear.

There are also many diagnostic methods, which will help clarify the diagnosis and indicate with great accuracy the localization of the pathological process in the central nervous system:

1. Magnetic resonance imaging (MRI) is the most modern and exact method. With its help, you can take layer-by-layer images of any organ. In ataxia, they help identify oncological tumors, degenerative processes, developmental anomalies and other deviations.
2. Computed tomography (CT) - modern beam method to obtain layer-by-layer images of internal organs. Contrasting with special liquids can also be performed.
3. Multislice computed tomography (MSCT) is very quick method scanning using special sensors that record X-rays passing through the patient's head. Using this type of diagnostics it is possible to identify tumor formations, inflammatory processes, hemorrhages, assess the speed of blood circulation.
4. Dopplerography of cerebral vessels is performed using ultrasound. The rate of blood circulation, vascular patency, intracranial pressure etc.
5. Ultrasound diagnostics of the brain helps to detect the growth or reduction of cerebellar tissue.
6. ECG and ultrasound of the heart are necessary for the development of degenerative processes in the heart muscle in the presence of chest pain, rhythm disturbances, etc.

The following tests may also be prescribed:

• general blood analysis;
• study of the level of immunoglobulins in the blood (IgA, IgE, IgG);
• PCR (polymerase chain reaction, the method is based on repeated doubling of a certain section of DNA using enzymes in artificial conditions) to identify pathological microorganisms;
• lumbar puncture (a procedure in which cerebrospinal fluid is taken from the spinal canal using a special needle) to study the cerebrospinal fluid;
• DNA diagnostics for detecting hereditary diseases.

To diagnose cerebellar damage, doctors perform a test for asynergia (impaired ability to produce combined movements). For this, the patient is asked to perform simple moves, in which the following disturbances in the combination of muscle action are visible:

• when walking, the body leans back, the person falls on his back;
• If you begin to tilt your head while standing, your knees will not bend and the patient will lose balance.

Differential diagnosis must be carried out with various brain tumors, Rendu-Osler-Weber disease, Hippel-Lindau disease, funicular myelosis, neurosyphilis, hereditary vitamin E deficiency, multiple sclerosis, Parkinson's disease and many other diseases.

Treatment

The treatment tactics for ataxia depend on its type and the stage of damage to brain structures. On initial stages You can get by with pharmacological drugs; they help slow down degenerative processes. In more advanced cases, the doctor may recommend surgical treatment to the patient.

Drug therapy

In case of ataxia, suspend pathological processes Pharmacological drugs help:

1. Antibacterial treatment is prescribed for infectious lesion(Tetracycline, Ampicillin, Bilmicin).
2. Vasoactive drugs are necessary for vascular disorders(Parmidine, Trental, Mexicor).
3. B vitamins are needed to maintain the functioning of the nervous system (Neuromultivitis).
4. To improve metabolic processes in nerve tissues administration of ATP and anticholinesterase drugs (Galantamine, Proserin) is indicated.
5. Antidepressants are prescribed for depressed emotional state(Amitriptyline, Citalopram).
6. Sedatives are necessary in the presence of psychomotor agitation (Magnesium sulfate, Valerian tincture).
7. Nootropic drugs are prescribed to improve brain function (Phesam, Piracetam).
8. Metabolic medicines necessary for Friedreich's ataxia (antioxidants, succinic acid, Riboflavin L-carnitine).
9. Neuroprotectors are needed to maintain the activity of the nervous system (Pyritinol, Meclofenoxate).
10. Medicines are prescribed that improve metabolism in the heart (Inosine, Trimetazidine).
11. Cholinomimetics are necessary to improve the transmission of nerve impulses in neurons (Gliatilin).
12. Immunostimulants are needed to maintain resistance to infections in patients with Louis-Bar syndrome (Immunoglobulin).

Surgery

Patients do not always need surgical intervention. However, in some situations conservative treatment does not give desired results and doctors strongly recommend resorting to surgery:

1. In case of detection of tumors, especially malignant ones, some patients are shown to have it surgical removal. Only a neurosurgeon can determine the operability or inoperability of a neoplasm.
2. If hair cells are damaged, the patient is recommended for cochlear implantation; it helps restore hearing and partially improve coordination.
3. Middle ear lavage is prescribed for acute and chronic otitis media which led to vestibular ataxia. The patient uses a special syringe to ear canal fluid with antibiotics, corticosteroids and other agents is administered.
4. Sanitation surgery of the middle ear is indicated for cleansing ear canals and restoration of bone tissue.

Physiotherapy and exercise therapy

1. Stand up, you can leave your arms at your sides or raise them up. Alternately lift the left and right leg, stay in these poses for as long as possible. Repeat the steps, only standing on your toes. To make it more difficult, you can perform the exercise with your eyes closed.
2. Take a light ball and mark a target on the wall at which you will throw it. It is necessary to practice accuracy, gradually lengthen the distance and use heavier objects.
3. To develop muscle-joint sense, you need to take objects with your eyes closed and describe their shape and approximate weight.

Can also be used various methods physiotherapy: ozone therapy, electrophoresis (impact on the body of constant electric shock in combination with the introduction through the skin or mucous membranes of various medicinal substances), myostimulation (exposure to the body with current through special electrodes that are applied to the body).

Video about therapeutic exercises for ataxia

Folk remedies

Ataxia is very serious illness, and it cannot be treated on its own. In most cases, it is not possible to achieve recovery using only folk remedies. But they can be prescribed after consulting a doctor as an auxiliary method. Can be used various herbs that help strengthen the nervous system:

• infusion of 3 teaspoons of peony root;
• infusion from tsp. chamomile, lemon balm and oregano flowers;
• infusion of half a glass of birch leaves, 3 tsp. chamomile flowers, spoons of honey.

All components must be poured with a glass of boiling water and left to steep for about two hours. Peony is taken 1 tablespoon 4 times a day, other infusions - 150 ml 3 times a day before meals.

Treatment prognosis

Doctors talk about favorable prognosis treatment of ataxia if drug therapy or surgical intervention can stop the development of degenerative processes and eliminate disturbances in the functioning of the nervous system. If the cause of the disease is genetic or has been discovered malignant tumor, the prognosis is usually unfavorable. In this case, specialists try to use treatment to stop the progression of the pathology and maintain the patient’s motor activity. Louis-Bar syndrome has a poor prognosis; children with this disease very rarely survive to adulthood. With Friedreich's ataxia, the prognosis is relatively favorable, many patients live more than twenty years from the onset of the first symptoms, especially if there is no damage to the heart muscle and diabetes. It is impossible to completely recover from genetic varieties of ataxia.

It is not always possible to become pregnant and give birth to a child. There may be contraindications that can be dangerous and even fatalities during childbirth. It is very important to consult with doctors in advance before planning the birth of your baby.

Very often in patients with different types ataxia, the following complications arise:

• paralysis and paresis (weakening motor activity) limbs;
• deterioration of vision and hearing;
• respiratory and heart failure;
• frequent relapses of infectious diseases;
• loss of the ability to move independently and take care of oneself;
• death.

Prevention

For future parents if they suspect hereditary forms ataxia, it is necessary to undergo examination by a geneticist to find out the risk of having a sick child. During 8–12 weeks of pregnancy, chorionic villi (the outer membrane of the embryo) can be tested to identify the presence of defective genes in the fetus. Consanguineous marriages should be avoided, as children may develop multiple genetic diseases.

Maintaining your health is also very important, it is worth excluding bad habits, promptly treat infectious diseases and try to prevent all kinds of head and spine injuries.

Ataxia is a very serious diagnosis in which dangerous complications. At the first signs of a violation of the coordination of movements, you should consult a doctor. Remember that many types of coordination disorders can be prevented if treatment is started in a timely manner. Unfortunately, inherited ataxias almost always progress and often lead to disability and even to fatal outcome. During pregnancy planning, you need to find out about cases similar diseases from your closest relatives or contact a geneticist for advice.