What are the Symptoms of Cerebellar Ataxia?

Ataxia means lacking coordination. Symptoms of ataxia may include a lack of coordination or poor coordination. This often presents as an unsteady walk, lurching or stumbling, or difficulty performing fine motor tasks such as writing, tying a pair of shoes, or buttoning a shirt. Many patients may also experience uncontrollable or repetitive eye movements, slurred speech, headaches, dizziness, or vocal changes.

Ataxia is generally a symptom of an underlying condition. Although in some cases this condition may be diagnosable, it is often unclear what is causing the ataxia. Testing may include blood, muscle, or nerve tests, brain, and spinal cord imaging, and genetic testing to narrow down the possible causes.

What Causes Cerebellar Ataxia?

Cerebellar ataxia, or cerebellar atrophy, may result from several causes. The condition may be caused by genetics, drugs or alcohol, head trauma, stroke, cerebral palsy, autoimmune disorders, or infections. Cerebellar ataxia may also be caused by medications such as Dilantin.

Dilantin is an anti-seizure medication often used for the treatment of epilepsy. The drug is also sometimes used to prevent seizures during or after brain surgery. Dilantin, also known by the generic name phenytoin, has been associated with cerebellar degeneration and atrophy.

According to a study published in Seizure, the European Journal of Epilepsy in 2018, Dilantin may be a leading cause of cerebellar atrophy in patients who have epilepsy. The study recruited 47 patients who had epilepsy and took phenytoin to control their seizures. The median duration of time that the patients had suffered from epilepsy was 24 years, with a median duration of 15 years of phenytoin treatment. All the patients in the study had taken phenytoin for at least one year. Neuroimaging was used to view the amount of cerebellar degeneration in each patient, and patients were also assessed for symptoms of ataxia.

Of the 47 patients, 40 percent were found to suffer from cerebellar ataxia. Additionally, 55 percent of the patients complained of symptoms related to cerebellar ataxia, such as loss of balance.  This may indicate that even patients who have no clinical evidence of cerebellar degeneration may be suffering from reduced cerebellar volume. Problems with patients’ walk, stance, and heel-shin slide were the most predominant symptoms recorded by the researchers.

Can Cerebellar Ataxia Be Reversed?

While many of the patients in the study had taken phenytoin for years or decades, only one patient had phenytoin levels that were higher than the normal range. This may indicate that even what has been considered a safe level of phenytoin exposure may be hazardous when taken over a long period of time.

Unfortunately, cerebellar ataxia is not reversible. Although there is currently no cure for cerebellar ataxia, some patients may be able to treat their conditions in order to reduce their symptoms.

According to a report published in Movement Disorders in June 2014, some patients suffering from cerebellar ataxia may be able to treat their symptoms with high doses of vitamin E, gluten-free diets, or prescription drugs. These treatment options depend on the type of cerebellar ataxia a patient has.

If the cerebellar ataxia is caused by drugs or alcohol, discontinuing the use of these substances may correct many of the symptoms. Ataxia caused by gluten may be treated by following a gluten-free diet. If the ataxia causes a vitamin E deficiency, taking vitamin E supplements may stop the progression of the disease and improve neurological side effects. However, these treatment options are time-sensitive and may be more effective the sooner after the diagnosis they are started.

Even types of cerebellar atrophy with no specific treatment options may be managed with physical or occupational therapy and adaptive devices. Patients who experience difficulty walking may find a cane, walker, or wheelchair helpful for improving their mobility. Physical and mental exercise, maintaining a healthy diet, and sleeping well may also be instrumental in managing the symptoms of cerebellar ataxia.

If you have developed cerebellar ataxia due to use of Dilantin or other drugs, you may be eligible to hire a qualified attorney and file a class action lawsuit. Victims who file class action lawsuits may be able to recover compensation for medical expenses, pain and suffering, and other damages.