During the operation to remove the large tumour in my brain, the surgeon had to push right past the cerebellum to reach the roof of the fourth ventricle. The cerebellum is the area responsible for fine movements, including the whole of balance and the mechanisms of speech, and the damage to it has caused me to suffer from ataxia.
Ataxia is a Greek term, which literally means “lack of order” and refers to incoordination.
Ataxia is a condition that causes a loss of physical co-ordination. It is usually caused by damage to a part of the brain called the cerebellum, but it may also result from damage to other parts of the nervous system.
The symptoms of ataxia can affect every part of the body and cause difficulties with:
There are 3 principal types of ataxia:
Impairment of cerebellar function
Sensory ataxia caused by reduced feedback from joint position receptors in the limbs
Vestibular ataxia due to impaired balance
Ataxia has many causes including genetic conditions, structural brain injury (e.g. following a stroke or bleed into the brain), birth injury and exposure to toxins.
People with cerebellar ataxia may initially present with poor balance, which could be demonstrated as an inability to stand on one leg or perform tandem gait. As the condition progresses, walking is characterised by a widened base and high stepping, as well as staggering and lurching from side to side. Turning is also problematic and could result in falls. As cerebellar ataxia becomes severe, great assistance and effort are needed in order to stand and walk. Dysarthria, impairment with articulation, may also be present and is characterised by "scanning" speech that consists of slower rate, irregular rhythm and variable volume.
Sensory ataxia is due to loss of proprioception, the loss of sensitivity to the positions of joint and body parts. Sensory ataxia presents itself with an unsteady "stomping" gait with heavy heel strikes, as well as a postural instability that is usually worsened when the lack of proprioceptive input cannot be compensated for by visual input, such as in poorly lit environments.
The term vestibular ataxia is employed to indicate ataxia due to dysfunction of the vestibular system, which in acute and unilateral cases is associated with prominent vertigo, nausea and vomiting.
In addition, I personally also suffer from this; primarily and inherently connected with my balance.
In some patients ataxia is part of a widespread neurological process, but it can occur on its own in individuals who are normal in every other way.
The causes and symptoms of ataxia vary hugely from person to person. My symptoms have, indeed, much improved over the years but tend to worsen when I am run-down, ill or very tired, as one tends to easily become after any sort of brain injury.
This is what my own, very eminent, neurologist has to say on the subject:
“It is important that patients with ataxia are fully investigated, and that they are supported to deal with their condition. It is my experience that patients with ataxia have enormous potential provided they can be helped to get around their coordination difficulties.”
Dr Oliver J F Foster MA PhD FRCP