Ataxy

Description:

Ataxy — a lack of coordination of movements, usually defiant disturbance of walking and balance (statics), but not connected with paralyzes.

Ataxy symptoms:

Allocate a sensitive, vestibular, cerebellar, frontal and psychogenic ataxy. The sensitive ataxy is caused by defeat of the fibers of deep sensitivity bearing information on position of a body in space and features of the plane according to which there is a person. This option of an ataxy can be connected with a polyneuropathy (for example, diphtheritic), the diseases of a spinal cord affecting its back columns in which fibers of deep sensitivity go back to a brain (for example, at multiple sclerosis, vascular or tumoral diseases) or a combination of these two types of frustration (for example, at deficit of B12 vitamin). Distinctive characteristics of a sensitive ataxy: deterioration in walking in the dark, identification at survey of disturbances of deep sensitivity (joint muscle sense, vibration sensitivity), considerable deterioration in balance in Romberg's pose when closing eyes, decrease or loss of tendon jerks. The patient with a sensitive ataxy goes carefully, trying to control sight each step and feeling "a wadded pillow" under foot, highly raises a leg and with a force lowers it all sole on a floor ("the stamping gait").

The vestibular ataxy usually accompanies damage of a vestibular mechanism of an inner ear or vestibular nerve (peripheral vestibulopathies), is more rare than trunk vestibular structures (see Dizziness). It usually is followed by rotary dizziness, faintness, nausea or vomiting, a nystagmus, sometimes decrease in hearing. Expressiveness of an ataxy increases at a certain position of the head and trunk, at turn of eyes. Patients avoid sharp movements by the head and carefully change position of a body. In some cases the tendency to falling towards the struck labyrinth is noted. Coordination in hands is not broken.

The cerebellar ataxy arises at damage of a cerebellum or its bonds. The patient costs and goes, widely placing legs and being shaken here and there and back and forth. Elimination of visual control (closing of eyes) influences expressiveness of koordinatorny frustration a little. The easy cerebellar ataxy can be revealed if to ask the patient to go on one line, putting a heel of one to a sock another (tandem walking). At selective involvement of a median part of a cerebellum the statics and walking are separately broken, when involving hemispheres the hemiataxia on the party of defeat which is shown by disturbance of accuracy of movements and intentsionny (arising in a final stage of purposive movement) a tremor which reveal at paltsenosovy and kolennopyatochny tests develops.

Ataxy reasons:

Intoxication medicines (lithium drugs, dipheninum, barbiturates, carbamazepine, an Ethosuximidum, benzodiazepines), the stroke, viral encephalitis,   cerebellum abscess can be the cause of an acute cerebellar ataxy. The subacute cerebellar ataxy develops at Gayet's encephalopathy — Vernika who is shown also an ophthalmoplegia and disturbance of consciousness and connected with deficit of B1 vitamin (at alcoholism, inadequate parenteral food, pernicious vomiting), poisoning with mercury, organic solvents, synthetic glue, gasoline or cytostatics, multiple sclerosis, a subdural hematoma. The paraneoplastic degeneration of a cerebellum (the remote effect of lung cancer, mammary gland, ovaries), hypothyroidism, alcoholic degeneration of a cerebellum, tumor of a back cranial pole, Arnold's anomaly — Kiari (omission of almonds of a cerebellum in a big occipital opening), a hereditary cerebellar ataxy can be the cause of the chronic progressing cerebellar ataxy.

Hereditary cerebellar ataxy (spinotserebellyarny degenerations) subdivide on autosomal and dominant and autosomal and recessive. The most frequent option of an autosomal and recessive cerebellar ataxy is Fridreykh's ataxy beginning at the age of 8 — 15 years with unsteadiness when walking and frequent falling. In addition to an ataxy, the areflexia, a dysarthtia, increase in a tone in legs, weight loss of muscles in distal departments of extremities, scoliosis, deformation of foot, a cardiomyopathy, a diabetes mellitus are observed. At autosomal and dominant cerebellar forms the ataxy is often combined with a hyperreflexia, a tremor and other ekstramidny frustration, amiotrofiya, an ophthalmoplegia, pelvic frustration. At hereditary spinotsersbsllyarny degenerations some effect sometimes render амантадин (Midantanum) and vitamin E. Irrespective of the reason the remedial gymnastics is important.

The frontal ataxy is shown by difficulties in a start of motion: the patient cannot long move a little, hardly tears off the "magnetized" legs from a floor, doing several "trial" small short steps or marking time. Having moved, it continues the movement by the small shuffling short steps. In hard cases because of balance disturbance patients are not able neither to stand, nor to sit without support (astasia abasia).

The psychogenic (hysterical) ataxy is expressed in the fancy changes of walking which are usually not observed at organic lesion of a nervous system. Patients can go on the broken line, slide as the skater on a skating rink, to cross when walking a leg as "weaving of a braid", to go on the straightened and divorced legs, as on stilts.

Treatment of the Ataxy:

Treatment of the main pathology is carried out.