Ataxia in children: early recognition and clinical evaluation

Abstract

BackgroundAtaxia is a sign of different disorders involving any level of the nervous system and consisting of impaired coordination of movement and balance. It is mainly caused by dysfunction of the complex circuitry connecting the basal ganglia, cerebellum and cerebral cortex.A careful history, physical examination and some characteristic maneuvers are useful for the diagnosis of ataxia. Some of the causes of ataxia point toward a benign course, but some cases of ataxia can be severe and particularly frightening.MethodsHere, we describe the primary clinical ways of detecting ataxia, a sign not easily recognizable in children. We also report on the main disorders that cause ataxia in children.ResultsThe causal events are distinguished and reported according to the course of the disorder: acute, intermittent, chronic-non-progressive and chronic-progressive.ConclusionsMolecular research in the field of ataxia in children is rapidly expanding; on the contrary no similar results have been attained in the field of the treatment since most of the congenital forms remain fully untreatable. Rapid recognition and clinical evaluation of ataxia in children remains of great relevance for therapeutic results and prognostic counseling.

Motor Function Improvement in Children with Ataxia Receiving Interval Rehabilitation, Including Vibration-Assisted Hometraining: A Retrospective Study

“…Further improvement in the follow-up, reflects the age-dependent natural development of the non-progressive disease, similar to findings reported among children with cerebral palsy over a six-month period [4]. Such a natural improvement is often not expected among children with progressive ataxia [21]. In fact, accord-ing to the literature, intensive rehabilitation training was less effective among patients with severe forms of progressive ataxia, in comparison to less severe ataxia forms [16].…”

“…Ataxia is a common sign in conditions affecting the cerebellum and its connections, as well as the afferent proprioceptive pathways, often classified as progressive or non-progressive [20]. Since causal treatment is rarely available, patients primarily receive supportive treatment [7,21]. Although supportive physiotherapy is crucial [5], the cost is not at all irrelevant [13].…”

Hemiataxia: A Novel Presentation of Anti-NMDA Receptor Antibody Mediated Encephalitis in an Adolescent

“…However, a variety of means can be used to identify the clear disturbance in amplitude modulation seen in ataxia/dysmetria, such as repetitive finger to object testing or testing of the ability to rhythmically and quickly modify hand position (finger, hand tapping, etc.). Ataxia is a common, nonspecific accompaniment of a number of congenital, posttraumatic, metabolic, and autoimmune conditions [ 18 ]. Manifestations can be bilateral or unilateral and variably affect the appendicular or axial musculature.…”

Advances in pediatrics in 2017: current practices and challenges in allergy, endocrinology, gastroenterology, genetics, immunology, infectious diseases, neonatology, nephrology, neurology, pulmonology from the perspective of Italian Journal of Pediatrics

“…Detecting ataxia can be challenging specially in early childhood but simple signs and maneuvers can help to recognize ataxia. In a recent review, Pavone and colleagues [ 132 ] provided a general approach to assessing and managing the patient with ataxia, they also reported the background and common etiologies of ataxia. Unsteadiness of gait with loss of balance is the more common symptom in younger children.…”