ATAXIA


3 clinical types: truncal, gait, and appendicular

  1. Truncal: when sitting up pt tends to drift backward into more supine position, without realizing it. Is an ataxia of the postural mm. Have trouble getting into desired position in bed. Lesions tend to be in inferior vermis
  2. Gait: unsteady, broad-based, "drunken" gait; unsteady while standing with feet together & eyes open (not Romberg's sign); produced by alcoholic cerebellar degeneration. Lesions tend to be in ant-sup. vermis. (n.b. truncal produces a distinct ataxia while walking)
  3. Appendicular: unsteadiness is in the limbs, with dysmetria on F==>N and H==>S & dysdiadochokinesis. Lesions tend to be in the cerebellar hemispheres

*paraneoplastic cerebellar degeneration--causes a pan-cerebellar degeneration with corresponding signs*

Treatment options are limited, though in case reports, varenicline has been associated with improvement (Acta Neurol. Scand. 119:135, 2009-JW)