4.1 Article

Ataxias: Hereditary, Acquired, and Reversible Etiologies

Journal

SEMINARS IN NEUROLOGY
Volume 43, Issue 1, Pages 48-64

Publisher

THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0043-1763511

Keywords

ataxia; cerebellum; cerebellar ataxia

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A variety of etiologies can result in cerebellar dysfunction, causing ataxia symptoms. Accurately diagnosing the cause for cerebellar ataxia can be challenging, but step-wise investigations have revealed nutritional, toxin, immune-mediated, genetic, and degenerative disorders as underlying causes. Recent advances in genetics have identified new genes for both autosomal dominant and autosomal recessive ataxias, and new therapies targeting specific biological pathways are being explored. New diagnostic criteria, particularly for multiple system atrophy, will greatly impact future clinical research in ataxia. This article provides a comprehensive review of the symptoms, laboratory testing, neuroimaging, genetic testing, and management strategies for cerebellar ataxia, with a focus on recent advances.
A variety of etiologies can cause cerebellar dysfunction, leading to ataxia symptoms. Therefore, the accurate diagnosis of the cause for cerebellar ataxia can be challenging. A step-wise investigation will reveal underlying causes, including nutritional, toxin, immune-mediated, genetic, and degenerative disorders. Recent advances in genetics have identified new genes for both autosomal dominant and autosomal recessive ataxias, and new therapies are on the horizon for targeting specific biological pathways. New diagnostic criteria for degenerative ataxias have been proposed, specifically for multiple system atrophy, which will have a broad impact on the future clinical research in ataxia. In this article, we aim to provide a review focus on symptoms, laboratory testing, neuroimaging, and genetic testing for the diagnosis of cerebellar ataxia causes, with a special emphasis on recent advances. Strategies for the management of cerebellar ataxia is also discussed.

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