Wednesday, July 8, 2009

Identify Ataxia

Ataxia, which translates as "lack of order", is a symptom rather than a disease itself that can be related to numerous neurological disorders. Most people who present with ataxia are older and may suffer from several different illnesses that affect the way the central nervous system works. However, ataxia can also be used as a tool with which to diagnose a patient.


Instructions


1. Look for gait disturbances. Most people with ataxia will have halting or lilted gaits that stop and start sporadically, or may seem to depend on one leg more heavily than the other. This is most indicative of cerebellar ataxia. This means that the cerebellum, which is the part of the brain that controls motor skills, is not functioning correctly.


2. Observe the patient when standing. In cerebellar ataxia, a patient will stand with his feet spread more than shoulder-width apart to maintain a sense of balance. When the feet are moved closer together, he may have difficulty standing erect, and will instinctively part his feet again.


3. Watch the patient for signs of lateral deviations when walking. Spino-cerebellar ataxia results in an almost drunken gait, marked by sideways steps that are often sudden and unexpected.


4. Look for intention tremors, which are tremors (shakes) in the limbs and trunk when the patient makes a voluntary movement. For example, if a patient's hand trembles when she reaches for a glass of water, she might be experiencing ataxia.








5. Watch for heavy heel strikes when the patient walks. Sensory ataxia usually presents with stomping when walking, usually planting the heel solidly before following with the toe.


6. Perform Romberg's test. This is a neurological diagnostic tool that requires the patient to stand straight in front of the examiner. With the eyes open, the patient raises one hand and points at the examiner, then closes his eyes. If the patient falls down upon closing the eyes, he is considered to have a positive Romberg's test, which indicates sensory ataxia.


7. Ask the patient about how she feels regarding equilibrium. A patient with vestibular ataxia will present with extreme vertigo, sometimes combined with vomiting and nausea.

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