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Ataxia and multiple sclerosis

Ataxia It is the term given to any number of abnormal movements that take place while doing some voluntary movement. It sounds pretty simple.

I guess when there are medical terms or definitions involved, things can get a bit (if not a lot) complicated for most of us, so I’ll try to put it in simple terms.

People with ataxia have trouble coordinating muscle movements. These problems often manifest themselves in the legs, but also in the arms, eyes, and muscles that are used to speak. Some of these involuntary movements cause you to experience incoordination or interruption in your movements. Many MS users have experienced this type of ataxia when we shoot below or above something that we intended or aimed at with the hand, arm, leg, or eye.

This lack of aim is a type of ataxia known as dysmetria. Since my diagnosis, I have started to experience hand dismetria. This can make writing and understanding difficult or even impossible.

Your cerebellum is the part of your brain that is responsible for synchronizing all voluntary muscle movements throughout your body, cerebellar ataxia is the result of injury to the cerebellum or the nerves that connect to it. Cerebellar ataxia can cause:

Uncoordinated gait: gait ataxia.

Inability to maintain a stable posture: hypotonia.

Tremor when trying fine movements: tremor of intention.

Inability to coordinate the muscles involved in speech – dysartia

Nervous eye movements – nystagmus

If the damage is localized to the spinal cord – its posterior columns to be more exact – the type of Ataxia that occurs is known as sensory ataxia.

Whenever you experience not knowing exactly where your extremities (hands and feet) are, you are experiencing sensory ataxia. Another manifestation of this type of ataxia occurs when you experience an unstable posture. Common problems with this type of ataxia are:

Loss of sense of position

Inability to detect vibrations.

Unstable posture also known as Romberg’s sign.

In multiple sclerosis, the last type of ataxia is known as vestibular ataxia, which is caused by injuries to the brainstem and vestibular nuclei. Common problems with this type of ataxia are:

Loss of balance

Dizziness

Nausea and

Vomiting (vertigo)

Nervous eye movements – nystagmus

Now I know that I experienced this type of ataxia when I had my first MS relapse. It came with loss of balance, dizziness, vertigo and a little nervousness in the eyes (nystagmus) plus optic neuritis that never really went away.

Contrary to what most people think, ataxia is not a direct result of muscle weakness (atrophy) but rather a dysfunction in the inputs of the sensory nerves or the outputs of the motor nerves.

HOW COMMON IS ATAXIA BETWEEN MSers?

It is estimated that 80-85% of people with MS will experience ataxia or tremors at some point during their illness. Ataxia is a fairly common symptom in multiple sclerosis, but it is also seen in other conditions such as:

1. Compression of the spinal cord

2. Diabetic polyneuropathy

3. Acute transverse myelitis

4. Vacuolar myelopathy

5. Tumors or compression of the cord and

6. Hereditary forms of ataxia

HOW IS ATAXIA TREATED IN MSers?

To help you manage these symptoms, there are currently several different treatments. They can be classified by:

Physiotherapy

Neurosurgery

Oral medications: some of them contain marijuana or cannabis extract, isoniazid or baclofen.

The Cochrane Collaboration, currently published in the Cochrane Database of Systematic Reviews 2010 Issue 11, Published by John Wiley and Sons, Ltd. concludes that there is insufficient evidence to suggest that any treatment (drugs, physical therapy or neurosurgery) provides sustained improvement. from ataxia or tremors.

The one thing that everyone seems to agree on is that more research is required.

Last but not least, along with the many problems caused by ataxia, you may experience tremors.

Tremors are rhythmic shaking movements of different amplitudes.

Whenever I stay in the same place for too long, I experience tremors in my right knee. These tremors are nothing serious and once I start to move, they just go away. While researching the topic, I discovered that tremors in people with MS primarily affect the head, neck, vocal cords, trunk, or extremities.

TIPS AND EXERCISES FOR ATAXIA

In ataxia the person presents.

• Incoordination
• Shaking
• Posture disturbances
• Balance and
• He passed

Physical therapy is aimed at promoting postural stability, precision of limb movements, and functional balance and gait.

Postural stability It can be improved by focusing on static control (grip) in a number of different weight bearing antigravity postures (eg prone, sitting, quadruped, kneeling, plantigrade, and standing). Progression through a series of postures is used to gradually increase postural demand by varying the base of support and raising the center of mass and increasing the number of body segments (degree of freedom) to be controlled. Specific exercise techniques designed to promote stability include:

• Joint approach applied through proximal joints (via shoulders or hips) or head or spine
• Alternate isometrics (PNF)
• Rhythmic stabilization (PNF)

The patient with significant ataxia may not be able to remain stable and may benefit from slow inversion retention (PNF) technique, which progresses through decreases in range. The desired end point is constant midrange retention. Dynamic postural responses can be challenged by incorporating controlled mobility activities such as:

1. Weight change
2. Swinging
3. Entering and exiting postures or movement transitions

The patient must practice significant functional movement transitions, such as supine to sit, sit to stand, and move.

Distal limb movements can be superimposed on proximal stability to further challenge dynamic postural control. For example, Resisted PNF Elevation or Chop patterns combined upper extremity movements with trunk movements (flexion or extension rotation with rotation).

An important goal of therapy is to promote a safe and functional balance. Static equilibrium Control can be improved through force platform training. The person with ataxia learns to reduce postural sway (frequency and amplitude) and control the center of alignment position. Additional biofeedback from the visual or auditory feedback screen may improve control in some patients. Somatosensory, visual, and vestibular inputs can be varied, as appropriate, to aid in sensory compensation in the less involved sensory system, for example:

• Standing with your eyes open to your eyes closed
• Standing on a flat surface on a foam surface

Long latencies (response initiation) should be expected. Dynamic balance control can be initiated by self-initiated movements (eg, Reaching, Turning, Crouching). A movable surface can also be used. For example, sitting on a Swiss ball is a great way to promote balance control.

Control of dysmetric movements of the limbs. It can be promoted by PNF limb patterns using slight resistance to moderate force production and muscle interactions, eg slow inversions, slow retention. Frenkel exercises it can be used to remedy the problems of dismetria. Exercises are performed supine, sitting, and standing. Each activity should be done slowly with the person using vision to guide and correct movement. The exercises require a high degree of concentration and mental effort.

For those patients with prerequisite skills, they may be helpful in regaining some control of ataxic movements through cognitive processes.

Ataxic movements have sometimes been aided by the application of light weights to provide additional proprioceptive load and stabilize the movements. The use of velcro weighted cuffs (wrist or ankle) or a weighted belt or jacket can reduce dysmetric movements and tremors of the extremities and trunk.

Additional weights will also increase energy expenditure and should therefore be used with caution so as not to lead to increased fatigue. Weighted canes or walkers can be used to reduce ataxic movements of the upper extremities during ambulation.

For patients with significant tremors, this can mean the difference between assisted and independent ambulation. Elastic resistance bands can be used to provide resistance and reduce ataxic movements.

The pool it is an important therapeutic means of practicing static and dynamic postural control when sitting and standing. The water provides a gradual resistance that slows the ataxic movement of the person, while the buoyancy helps maintain an upright balance.

Swimming and calisthenics in shallow water have been shown to be effective in improving strength, decreasing muscle fatigue, and increasing endurance. Also, using moderate or cold water can help moderate spasticity. In general, people with ataxia do best in a low-stimulus environment that allows them to focus more fully on their movements. They benefit from augmented feedback (verbal indication of knowledge of results, knowledge of performance, biofeedback) and repetition to improve motor learning.