Friedrich's ataxia
The treatment for ataxia can vary depending on exact what type of ataxia you have.
It's sometimes possible to treat the underlying cause of the condition so it improves or stops getting worse, but in most cases this isn't possible and you'll have treatment to relieve your symptoms.
You'll usually be cared for by a group of healthcare professionals called amultidisciplinary team (MDT), who willwork with you to come up with a care plan. Your MDT will probably include a neurologist, physiotherapist and specialist nurse, among others.
Your care plan will playan important part in the management ofyour condition. Your physical, social and psychological needs will be assessed, and the plan will outlinehow these needs can best be met. The plan will also address any futureneeds you may have.
You'llnormallyhave regularappointments with your MDT or GP to review your progress. In some cases, you may be seen in a specialist ataxia centre.
Treatments for the various symptoms of ataxia are discussed below, although you may not experience all of the problems described.
A speech and language therapist will be able to help with two of the most common symptoms of ataxia slurred speech (dysarthria) and swallowing problems (dysphagia) .
The therapist will be able to advise youabout how to make your voice sound clearer. For example, they may suggest:
If your speech gets worse, you may want to consider using speaking aids such as a laptop computer connected to a voice synthesiser. Your therapist will be able to advise you about the equipment available.
To treat dysphagia, your therapist will be able to teach you exercises to stimulate the nerves used to trigger your swallowing reflex and strengthen the muscles used when swallowing.
You may also be referred to adietitian for dietary advice. For example, your diet may need to include food that's easier to swallow.
The aim of occupational therapy is to teach you how to adapt to your gradual loss of mobility and develop new skills you can use to carry out daily activities.
An occupational therapist may be able to teach you how to use a wheelchair and other mobility devices. They can also advise you about modifications you can make to your house, such as installing guide rails or a stair lift, to help make your life easier.
If you have ataxia, physiotherapy can help you maintain the use of your arms and legs, and prevent your muscles weakening or getting stuck in one position (contractures).
A physiotherapist will be able to teach you a number of physical exercises you can do every day to help strengthen and stretch your muscles. They may also be able to recommend walking aids to help you get around.
If you're experiencing muscle spasms, cramps and stiffness, muscle relaxant medication such as baclofen or tizanidinemay be used to control these symptoms.
If these aren't effective, an injection of botulinum toxin (Botox) may be given. This works by blocking the signals from yourbrain to the affected muscles. The effects of the injection will usually last for up to three months.
Bladder problems, such as urinary urgency or, more rarely, urinary incontinence , sometimes affect people with ataxia.
In some cases, bladder problems can be controlled using a number of self care techniques, such as limiting fluid intake during the day, planning regular trips to the toilet,and avoiding drinks known to stimulate urine production, such as caffeine and alcohol.
Some people may also require a type of medication known as antimuscarinic. This will help relax the bladder, reducing the frequent urge to urinate. Occasionalinjections of botulinum toxin into the bladder may also help.
Others may find it difficult to empty their bladder completelywhen they go to the toilet. This can lead to small amounts of urine leaking out later on. In such cases, it may be necessary to insert a small tube known as a urinary catheter into the bladder to help drain the urine.
Eye problems arecommon in some cases of ataxia. Oscillopsia is an eye problemcaused by involuntary movement of the eyes from side to side or up and down. It can cause visual disruption, making tasks such as reading difficult. Thiscan sometimes be treated using medication such as gabapentin to control the muscles that move the eyes.
Some people with ataxia experience double vision , where you see two images of a single object. It may be possible to treat this by attaching a wedge-shaped piece of glass or plasticcalled a prism to your glasses.
As a result ofunderlying nerve damage, some men with ataxia will experiencedifficulty getting or maintaining an erection (erectile dysfunction) .
Thiscan often be treated using a group of medications known as phosphodiesterase-5 (PDE-5) inhibitors, such assildenafil (sold as Viagra). These help increase blood flow to the penis.
It's thought this is partly caused by disturbed sleepand the physical efforts of having to cope with the loss of co-ordination.
A physiotherapist may be able to help youincrease your stamina levels, and an occupational therapistcan advise youabout how to adapt your daily activities to help you cope with fatigue better.
Damage to the nerve endings can result in nerve pain. The medical term for nerve pain is neuropathic pain, which is often experienced as a burning, achingor shooting pain, or sometimes tingling, in certain parts of the body.
Traditional painkillers such as paracetamol or ibuprofen aren't usually effective in treating neuropathic pain, so you may be prescribed a number of medications, such as amitriptyline, gabapentin or pregabalin.
This can be seriousasit can place strain on the heart, affect the normal blood flow through the heart, and cause heartbeat irregularities (arrhythmias).
If you develop cardiomyopathy, you'll receive regular check-ups from a cardiologist (a heart specialist). You may need to take medication to treat any problems as they develop.
Living with a long-term condition such as ataxia can be stressful and can often causeintense feelings of anxiety. In some cases, this can trigger the onset of depression .
Signs that you may be depressed include feeling down or hopeless during the past monthand no longer taking pleasure in thethings you enjoy.
You should contact your GP or MDT for advice if you think you may be depressed. There areseveral treatments for depression, such as antidepressants and talking therapies such as cognitive behavioural therapy (CBT) .
You may also find it useful to contact Ataxia UK , a leading charity for people affected by ataxia. Their helpline number is0845 644 0606, openMonday to Thursday, 10.30am to 2.30pm.
In a few cases of ataxia, it may be possible to improve the condition or stop it getting worse by treating the underlying cause.
For example:
Ifacquired ataxia iscaused byserious underlying brain damage, such as damagefrom a stroke or a severe head injury , it may not be possible to improve the condition. If this is the case,the treatments mentioned above can be used tocontrol your symptoms.
Ataxia is the term for a group of disorders that affect co-ordination, balance and speech. Find out about the main types, what causes them, and how they're treated.
Read about some of the main types of ataxia, including when they develop and what the outlook is.
Read about the main causes of ataxia, including how some types are passed on to a child by their parents.
Read about the tests and examinations you may need for your doctor to diagnose ataxia and determine which form of the condition you have.
Read about the treatments, support and care available for people with different types of ataxia.