Gait/Posture abnormalities - Difficulty maintaining normal upright posture, balance, coordinated walking, and running. Unsteady gait, staggering, tripping, falling, unsteadiness on stairs or maintaining balance on moving platforms, such as escalators or boats. These difficulties are often due to cerebellar dysfunction.
Fine motor incoordination - Difficulty with handwriting, cutting food, opening jars, buttoning clothes, sewing, typing, playing an instrument or a sport.
Speech and swallowing difficulties - Speech: slurred, slow, indistinct, abnormal in rhythm. Swallowing: difficulty swallowing or choking (especially with liquids).
Visual abnormalities - Blurred vision or double vision. Reading: difficulty moving from word to word. Problems following moving objects or shifting gaze from one object to another.
Increased fatigue - Patients with ataxia due to cerebellar atrophy often experience unexpected fatigue when performing normal activities. The impaired regulation of coordinated movements may lead to increased fatigue because of the need to expend more effort to perform activities that are no longer fluid or coordinated. Patients with ataxia often report needing to “concentrate on” their movements.
Cognitive and Mood Problems - In addition to motor dysfunction, patients with cerebellar degeneration may have cognitive and emotional difficulties. The cerebellum plays a role in some forms of thinking. Patients with cerebellar atrophy may have impaired recall of newly learned information or difficulty with “executive functions” such as making plans and keeping thoughts in proper sequence. Personality and mood disorders, such as increased irritability, anxiety, and depression, are more common in persons with cerebellar degeneration than in control subjects. It is important to examine mood and cognitive function in patients with cerebellar problems. These disorders are likely to respond to treatment, such as cognitive exercises, psychotherapy, and pharmacological treatment.
Patients with cerebellar ataxia may have symptoms that involve many aspects of life and vary significantly from person to person. Patients with ataxia should remain in close contact with a primary physician, neurologist, psychiatrist or psychologist, and with physical, speech and swallowing, and occupational therapists so that new difficulties can be recognized and treated early to reduce future injury.