Ataxia

Ataxia is a lack of coordination of muscle movements which can appear as clumsiness, unsteady gait, impaired eye and limb movements, speech problems and sometimes dizziness. Its impact varies and depends on which part, and how much, of the nervous system has been damaged by MS.

Ataxia is most often caused by disease activity in the cerebellum (the part of your brain that controls muscle coordination and balance).

Movements such as walking and speaking involve complex messages from the brain and feedback from the nerves. Nerve fibre damage from MS can delay or interrupt the matching of these messages, resulting in ataxia.

The three types of ataxia relate to the location of the nerve damage and can occur in isolation or together:

• Sensory Ataxia occurs when there’s damage to the sensory pathways that control the messaging between the spinal cord and the limbs. This interferes with the person’s ability to know where the parts of the body are in relation to each other and to their surroundings. This is known as proprioception. For example, this can cause the person to have a ‘stomping walk’ as they cannot judge where their legs are in relation to the ground.
• Vestibular Ataxia occurs when there’s damage to the cranial nerve and the person may experience dizziness or unsteadiness.
• Cerebellar Ataxia occurs when there’s damage to the part of the brain that looks after coordination and motor control. This can cause floppiness, lack of coordination and an inability to control power and speed of movement.

If you have ataxia concerns, talk to your neurologist, MS Nurse or GP, or ask to be referred to the appropriate specialist.

Physiotherapists, occupational therapists and rehabilitation specialists can provide individualised programs to help manage ataxia effectively. It’s important that this is done under the supervision of a health professional, to ensure you are properly assessed and an individualised plan is tailored for your needs. Sometimes, ataxia can be only short-term following a relapse, but for others, symptoms can be longer lasting.

Treatment for ataxia depends on the cause, but usually involves a combination of rehabilitation and compensatory strategies. Adaptive devices, such as walkers or canes, might help you maintain your independence, both short and long term. Physical therapy, occupational therapy, speech therapy and regular aerobic exercise might also help, as well as developing compensatory strategies and doing activities that challenge your sense of balance and coordination, even if you find it hard.