Ataxia

What are the standardized measures for ataxia?

BARS SARA Brief ataxia rating scale Scale for assessment and rating of ataxia

For acquired ataxia, what are the areas affects by PICA and SCA infarcts? WHat are the clinical signs of PICA and SCA infarct?

PICA: inf cerebellum, inf vermis, lateral medulla SCA: sup cerebellum and vermis, upper pons, sup ped nystagmus, gait ataxia, limb ataxia, vertigo

why is there coordination meausre on FMA motor exam?

coordination is to determine if CVA is typical MCA infarct or other origin as a screen

what are the three types of cerebellar ataxia?

degenerative acquired hereditary

Sensory ataxia pathologies for degenerative acquired hereditary

degenerative: neuropathis like DM and idiopathic acquired: infectious and traumatic hereditary: charcot-maire tooth, and chronic inflammatory demyelinatinf polyneuropathy

Definition of ataxia CLinical signs of cerebellar ataxia Sensory ataxia?

discoordination of movement following damage to cerebellar or sensory systems cerebellar includes dyscoordination, post control deficits and gait ataxia, but also dysarthria/dysphagia and oculomotor dysfuction, asthenia(fatigue), tremor, and hypotonicity Sensory includes dyscoordination, gait ataxia, and postural control deficit, but also proprioception loss

Documentation of ataxia:

document clinical signs, severity, and velocity Ex: pt demonstrates moderate dyskinesia with heel to shin with moderate decrease in velocity 3-5 attempts

CLinical signs for ataxia: dysmetria dysdiadokokinesia tremor what types of tremors are there? Asthenia Postural control deficit high low Gait Oculomotor Dysarthria

dysmetria: test: FTN, undershoot/overshoot Dysdiadokokinesia: hand flip unilateral and then bilateral (impaired rhythm) Tremor (observation of rest, action, or posture tremors of head, tongue, trunk or UE/LE tremors) Astenia is subjective report Postural control deficit: can observe sitting or high: test SLS and tandem Gait: low: observation. High: mDGI Oculomotr smooth pursuit and saccades during CN exam Dysarthria: observe speech

Appendicular ataxia WHat is lesioned?

lateral motor systems for appendicular control and ataxia wide-based, unsteady gait

truncal ataxia what is lesioned? what is gait like

lesion is of the vermis, primarily affecting the medial motor system Gait is wide-based and unsteady

sensory ataxia clinical signs what are tests for them? Positive findings?

sensory loss fine touch, joint position sense, impaired kinesthesia FTN with eyes closed and HTS with eyes closed positive finding is difficulty finding nose or shin asthenia Subjective reports of weakness or fatigue gait imbalance observation or DGI wide-based, arrhythimic, with varied step length or height postural control deficit rhomberg or SLS or tandem stance Positive is able to perform some tests with eyes open but not eyes closed

what are tests with good to excellent reliability commonly used in clinical setting?

timed heel to shin timed finger opposition timed pronation/supination

examination: coordination tests: How do timed tests compare to ordinal tests?

timed tests are more reliable than ordinal tests Alternating Heel to knee/ankle, heel on shin, and finger-to-nose timed