MSA-C (Cerebellar Ataxia)

Symptoms and Treatments

Cerebellar Ataxia Symptoms

Cerebellar ataxia is characterized by a lack of control of postural muscles combined with decreased coordination of the arms and legs resulting in a wobbly, wide-based, staggering gait. Distinct from the shuffling gait of Parkinsonism, the wide stance of cerebellar ataxia helps patients feel more stable and prevents falls and injuries. If you are affected by this condition you may also experience imprecise control of your arms and hands when you reach for, grasp and manipulate objects with your hands. Muscles that control speech can also be affected in this condition, leading to slurred, drunken-sounding speech. Additionally, tremors can occur, particularly of the head and upper trunk, but also in the arms, legs and lower trunk, depending upon which parts of the cerebellum are affected.

 

Nonpharmacological Treatment

Physical Therapy

Physical therapy works to improve an individual’s balance and gait so that the patient can try to be as independent as possible. The goal of physical therapy is to help promote the patient’s awareness of his/her, own body which will help with coordination and tasks. Physical therapy can work to maintain and strengthen the legs, back, and abdomen to improve walking. Also, therapists may show patients exercises to practice their eye and muscle coordination. Other activities that may be beneficial are yoga, tai chi, and Alexander technique, a form or relaxation and therapy that may be provided by some physical therapists, to continue being active and to practice mindful movement.

Occupational Therapy

Occupational therapists work to improve the daily activities of individuals to improve their mobility and can help identify possible falling risks at home. For instance, video games can improve hand-eye coordination, which may be beneficial to dexterity in patients.

Acetyl-DL-leucine

A publication described the benefits of amino acid acetyl-DL-leucine in some types of degenerative cerebellar ataxia. This study showed that 5 grams of actyl-DL-leucine per day for a week decreased ataxia rating scores by 20%. Also, there were improvements in gait, speech, and motor coordination3.

Speech Therapy

As in MSA-P, speech therapy can be useful in dealing with similar symptoms seen in MSA-C.

Pharmacological Treatment

Overall, there are no therapies that modify disease progression in MSA, PD, or other related disorders. There are some that will be used in an attempt to improve symptoms, but these are used on an individual basis.

Gabapentin

Gabapentin, also known as Neurotonin, is a medication that modulates gamma-aminobutyric acid (GABA) levels in the brain. Gabapentin has a relatively safe medication profile with few side effects. These side effects would be fatigue, sleepiness, dizziness, rolling eye movements, and weight gain. It can help with pain, stiffness, sleep problems, and to stabilize mood.

Pregabalin

Also known as Lyrica, pregabalin works very similarly to gabapentin by modifying GABA concentrations in the brain. This medication is considered to be stronger than gabapentin. Side effects may include double vision, tremor, and impaired cognition.

Baclofen

As in MSA-P this medication works by modifying GABA in the brain and can improve spasticity. Side effects of this medication include impaired cognition, irregular heartbeats, drowsiness, fatigue, and changes to bladder function.

 

For all references listed in the About MSA section please download the MSA Coalition's "MSA - What You Need to Know"

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