Ataxia is what? Symptoms and types of ataxia
Ataxia is not accompanied by paralysisviolation of motility, the characteristic features of which are disorders of rhythm and coordination of movements. In Greek, the word ataxia means "randomness" and "randomness".
With this diagnosis, the movements becomedisproportionate, awkward, inaccurate, walking often suffers, and in some cases even speech. Consider what types of ataxia are distinguished, and what are their characteristic features.
Friedreich's Ataxia
Friedreich's hereditary ataxia isgenetically determined neurological disease, which is progressive. The initial manifestations of the ailment become noticeable in the first few decades of life.
First, there are violations of handwriting and gait. For children, however, it is difficult to detect a violation of handwriting because it has not yet completely formed. As for the gait, the patient needs support, he constantly swings. All leg movements are more jerky than progressive.
Over time, the inability to stand (astasia) and even walk (abasia) is developing. However, the latter is a characteristic manifestation of the rapidly progressing course of the disease and its last stages.
There are changes in the spine, especiallyis relevant for adolescents who have not yet completed the process of its formation. After several years, the patient due to disruptions in the pancreas develops diabetes. A little later, in view of the dystrophic changes in the sexual glands, hypogonadism occurs. At the last stages of ataxia, there is a visual disturbance that arises as a result of dystrophic changes in the optic and oculomotor nerves. In addition, due to damage to neurons of the brain, dementia develops.
Cerebrovascular disease
Cerebellar ataxia is a disordermotor coordination, developing with the defeat of the main responsible for it, the organ - the cerebellum of the brain. In some cases, minor changes develop, but in others, more serious and severe.
The development of such an ataxia occurs due toaffecting various areas of the cerebellum pathological process. Often, cerebellar ataxia is diagnosed with encephalitis, vascular diseases of the cerebellum, multiple sclerosis, malignant brain tumors, intoxications, as well as individual ailments of genetic origin. There are 2 types of cerebellar ataxia - static and dynamic.
Static character of cerebellar ataxia
The defeat of the cerebellum is expressed in a staticataxia due to a reduction in muscle tone. In this process, it becomes difficult for a patient to stay in one position for a long time, and an insignificant violation of motor coordination is observed in him. The person moves very wide and staggering steps, as if in a state of intoxication. In the case of a severe course of the disease, the patient is unable to sit and stand on his own, as he does not even have the strength to restrain his head, he constantly falls. Static ataxia in severe form deprives the patient of the ability to independently maintain equilibrium. It is worth noting that motor coordination is not affected by whether the patient is open or with closed eyes.
The dynamic nature of cerebellar ataxia
Dynamic ataxia develops when involvedcerebellar hemispheres in the pathological process. With this type of disease, coordination disorders are observed only in the case of physical movement. Fade and accuracy of movements are lost, they become sweeping and awkward. Discoordination and slowing down of movements are observed on the side of the lesion. Dynamic ataxia is characterized by hypermetry (excessive, opposite movements), adiadochokinesis, misses, as well as intentional tremor and speech disorders (patients speak slowly, dismembering words into syllables).
In the standing and walking position, the patient deviatesin the corresponding damaged hemisphere of the cerebellum side. The patient's handwriting changes: it becomes uneven, sweeping, with large letters. It is not excluded the decrease of tendon reflexes.
Sensitive ataxia
This ataxia is a disorder of movement, withwhich changes in gait due to loss of sensation in the legs, which is a consequence of damage to the peripheral nerves, medial loop, posterior columns or posterior roots of the spinal cord. The patient does not feel the position of the legs, and therefore experiences difficulties both in walking and standing. As a rule, he stands with widely spaced legs and at the same time can keep his balance only with his eyes open, if they are closed, the person will start to stagger and, most likely, fall (Romberg's positive symptom). When walking, patients also widely spread their legs and raise them much higher than necessary, and also swing violently back and forth. Their steps have a different length, and feet, touching the floor, make popping sounds. The patient, when walking, usually uses a stick for support and flexes a few trunks in the hip joints. Gait disturbance aggravates visual defects. Often patients lose stability, swing and fall when washing, as, closing their eyes, they lose visual control for a while.
Spinocerebellar ataxia
This term refers to the set of motordisorders, arising in the majority because of ischemic injuries of the CNS in the perinatal period or hypoxia. The severity of the change in gait may be different and depends on the severity and nature of the lesion. Thus, light limited lesions can cause Babinsky's symptom, an increase in tendon reflexes and not be accompanied by a pronounced change in gait. Extensive and more pronounced lesions usually entail bilateral hemiparesis. There are changes in gait and postures, characteristic of paraparesis.
Cerebral palsy produces motordisorders that entail a change in gait. In patients with this, there are involuntary movements in the limbs, which are accompanied by grimaces on the face or rotational movements of the neck. As a rule, the legs are stretched, and the arms are bent, however this asymmetry of the limbs can become noticeable only when the patient is closely watched. So, for example, one hand can be pierced and stretched, and the other is clotted and bent. The asymmetric position of the limbs often arises when the head rotates in different directions.
Diagnosis of ataxia
To establish the diagnosis, the following diagnostic methods are used:
- MRI of the brain;
- brain electroencephalography;
- DNA diagnostics;
- electromyography.
In addition to any of the indicated methods, it is necessary to take a blood test, undergo an examination with specialists such as neuropathologist, psychiatrist and oculist.
Treatment of ataxia
Ataxia is a serious disease requiringtimely action. Treatment, which is carried out by a neurologist, is mainly symptomatic and includes the following directions.
- General strengthening therapy (anticholinesterase drugs, "Cerebrolysin", ATP, B vitamins).
- Physiotherapy aimed at preventing various kinds of complications (muscular atrophy and contracture, for example), improving walking and coordination, maintaining physical fitness.
Special gymnastic complex of exercisesLFK, whose goal is to reduce discoordination and strengthen the muscles. With a radical method of treatment (surgery of cerebellar tumors, for example), one can expect a partial or complete recovery, or at least a cessation of further progression.
At Friedreich's ataxia, if we take into accountpathogenesis of the disease, a huge role can play a drug aimed at maintaining the functions of mitochondria (Riboflavin, vitamin E, coenzyme Q10, succinic acid).
Prognosis for the disease
The prognosis of hereditary diseases israther unfavorable. Over time, especially with inaction, neuropsychiatric disorders only progress. In people with a diagnosis of "ataxia", the symptoms of which become more pronounced with age, as a rule, work capacity is significantly reduced.
However, due to symptomatic treatment, as well as the prevention of intoxications, injuries and infectious diseases, patients live to the advanced age.
Prevention
It is necessary to avoid blood marriages. In addition, it should be remembered that the probability of transmission of hereditary ataxia from the parent to the child is great, and therefore patients are often recommended to abandon the birth of their own babies and adopt another's child.
Ataxia is a serious neurologicaldisorder, the treatment of which must be started immediately. That is why the earlier this illness was revealed, the more favorable for the patient will be the prognosis.
