Pediatric ataxia
Ataxia (atax·ia) is a disease where your child loses the ability to make smooth, controlled movements. Depending on what type of ataxia your child has, they might have trouble walking, speaking or keeping their balance. At Children's Health℠, our specialists help your child manage their symptoms and identify the cause of their ataxia.
What is pediatric ataxia?
Children with ataxia have difficulty with muscle control and basic coordination. For example, they might struggle with fine motor skills (like holding a pencil), walking, or having a hard time picking up objects. Ataxia can result from injuries at birth (such as cerebral palsy CP) or from trauma (like a major car accident). Ataxia can also come from inherited conditions or exposure to toxins that damage the brain.
What are the different types of pediatric ataxia?
There are between 50 and 100 types of ataxias in total.
The three main types are:
Cerebellar ataxia is caused by damage to the part of the brain that controls balance and coordination, which is called the cerebellum. This type of ataxia can impact the accuracy of body movements, the control of eye movements, learning new movements, and the control of behavior.
Sensory ataxia is caused by a loss of sensation. If the body can’t sense where it is in space, it can’t give feedback to improve the accuracy of movements. This type of ataxia can follow damage to the brain, spinal cord, or nerves outside the brain and spinal cord that are known as the peripheral nervous system.
Vestibular ataxia is caused by damage to the systems that control your balance. These include the inner ear, the oldest parts of the brain (the brainstem) and the connections between the inner ear and the brainstem.
What are the signs and symptoms of pediatric ataxia?
Cerebellar ataxia
Fatigue
Low muscle tone
Muscle tremors
Slurred speech
Voice changes
Trouble with walking and coordination
Wide stance
Poor vision
Sensory ataxia
Inability to sense where the body is with the eyes closed
Falling when the eyes are closed, such as when shampooing hair
Stomping or walking with heavy footsteps
Trouble walking in dim lighting
Inability to sense vibrations
Vestibular ataxia
Problems standing and sitting upright
Trouble walking in a straight line
How is pediatric ataxia diagnosed?
Ataxia is diagnosed by a physical exam with one of our pediatric ataxia experts. During the exam, your child’s doctor will test each brain system that can cause ataxia to identify which type of ataxia your child has.
For example, testing of eye movements is important for finding a cerebellar ataxia, but testing sensation in the hands and feet is important for finding a sensory ataxia.
Your doctor may:
use blood tests to find the cause of the ataxia
order an EMG (a test that looks for abnormal muscle activity)
order an MRI (which takes detailed images of your child’s brain or spine) to understand the cause of the ataxia
However, the diagnosis of ataxia is based on the physical exam.
What causes pediatric ataxia?
Causes of ataxia may include:
Autoimmune diseases (multiple sclerosis, autoimmune encephalitis, and other types)
Hereditary ataxias (including Ataxia-telangiectasia, episodic ataxia, Friedreich's ataxia, spinocerebellar ataxias and Wilson’s disease)
Rare response to a cancerous tumor (known as paraneoplastic syndromes)
Toxic reaction (to barbiturates, sedatives or chemotherapy)
Vitamin E, vitamin B-12 or thiamine deficiency
An abnormal cluster of cells in the brain (known as a brain tumor)
An interruption or restriction of the blood supply to the brain (known as a stroke)
How is pediatric ataxia treated?
Treatment for ataxia depends on what causes it. For example, if a child has a vitamin E or vitamin B12 deficiency that’s causing ataxia, we can give your child extra vitamins to make their symptoms disappear.
In most cases, your child’s doctor will manage ataxia symptoms with the goal of preventing the ataxia from getting worse.