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Evaluation of Ataxia

The examination of a person with ataxia will likely include each of the following:

Thorough medical history, including questions regarding:

  • Onset of ataxia (acute vs. rapid vs. slow)
  • exposure to toxic substances, drugs, medications
  • recent viral illness
  • family history
  • autonomic symptoms, including control of blood pressure (problems with the autonomic system may suggest a diagnosis of multiple system atrophy)

Neurologic exam, for evidence of:

  • ataxic symptoms (examine all body regions)
  • additional neurologic signs, suggestive of secondary causes or specific diagnoses

Lab studies, including:

  • Imaging (for lesions, cerebellar atrophy, evidence of stroke, etc.)
  • Blood tests, especially for vitamins B12 or E deficiency, infection, metabolic syndromes, Wilson's disease
  • Urinalysis
  • Cerebrospinal fluid (for multiple sclerosis, infectious causes, neoplasm or paraneoplastic syndrome, inflammation)

Autonomic testing, when multiple system atrophy (MSA) is suspected

Genetic testing, when a family history indicates the patient likely has one of the inherited ataxias. Commercial genetic tests are available for the most common forms.