{"id":46491,"date":"2020-11-11T06:09:09","date_gmt":"2020-11-11T06:09:09","guid":{"rendered":"https:\/\/www.homeobook.com\/?p=46491"},"modified":"2022-01-05T03:29:14","modified_gmt":"2022-01-05T03:29:14","slug":"cerebellar-ataxia-and-related-homoeopathic-remedies","status":"publish","type":"post","link":"https:\/\/www.homeobook.com\/cerebellar-ataxia-and-related-homoeopathic-remedies\/","title":{"rendered":"Cerebellar ataxia and related Homoeopathic remedies"},"content":{"rendered":"
Dr Mansoora\u00a0 <\/span>K<\/b><\/span><\/p>\n Cerebellar ataxia results\u00a0in a characteristic type of irregular, uncoordinated movement that can manifest itself in many possible ways, such as asthenia, asynergy, delayed reaction time, and dyschronometria.<\/span><\/p>\n CEREBELLAR\u00a0 <\/span>ATAXIA: People with cerebellar ataxia may have trouble regulating the force, range, direction, velocity and rhythm of muscle contractions<\/span><\/p>\n Etiology:<\/b><\/span><\/p>\n Asthenia <\/span>\u00e0<\/span>abnormal physical weakness or lack of energy<\/span><\/p>\n Asynergy<\/span>\u00e0<\/span>absence of coordination of organs or body parts that usually work together harmoniously<\/span><\/p>\n Dyschronometria<\/b> is when a person can not accurately estimate the amount of time that has passed.<\/span><\/p>\n Dysmetria<\/b> (English: difficult to measure) refers to a lack of coordination of movement typified by the undershoot or overshoot of intended position with the hand, arm, leg, or eye. It is a type of <\/span>ataxia <\/span> It is sometimes described as an inability to judge distance or scale.<\/span><\/p>\n People with cerebellar ataxia may initially present with poor balance, which could be demonstrated as an inability to stand on one leg or perform <\/span>tandem gait <\/span><\/p>\n As the condition progresses, walking is characterized by a widened base and high stepping, as well as staggering and lurching from side to side.<\/span><\/p>\n Turning is also problematic and could result in falls. <\/span><\/p>\n As cerebellar ataxia becomes severe, great assistance and effort are needed in order to stand and walk.<\/span><\/p>\n Dysarthria<\/b> <\/span> an impairment with articulation, may also be present and is characterized by “scanning<\/b>” speech that consists of slower rate, irregular rhythm and variable volume.<\/span><\/p>\n There may also be slurring of speech, tremor of the voice<\/span><\/p>\n There is overshooting with finger to nose testing, and heel to shin testing; thus, <\/span>dysmetria<\/span> is evident.<\/span><\/p>\n Impairments with alternating movements (<\/span>dysdiadochokinesia<\/span>), as well as <\/span>dysrhythmia<\/span>, may also be displayed. <\/span><\/p>\n There may also be tremor of the head and trunk (<\/span>titubation<\/span>) in individuals with cerebellar ataxia<\/span><\/p>\n The dysfunction of the vestibulocerebellum<\/b> <\/span>(flocculonodular lobe) impairs the balance and the control of eye movements. <\/span><\/p>\n This presents itself with postural instability, in which the person tends to separate his\/her feet upon standing, in order to gain a wider base and to avoid titubation (bodily oscillations tending to be forward-backward ones). <\/span><\/p>\n The instability is therefore worsened when standing with the feet together, regardless of whether the eyes are open or closed. This is a negative Romberg’s test,<\/b> or more accurately, it denotes the individual’s inability to carry out the test, because the individual feels unstable even with open eyes<\/span><\/p>\n Dysfunction of the spinocerebellum <\/b>(vermis and <\/span>associated areas near the midline) presents itself with a wide-based “drunken sailor” gait (called truncal<\/b> ataxia<\/b>),characterised by uncertain starts and stops, lateral deviations, and unequal steps. <\/span><\/p>\n As a result of this gait impairment, falling is a concern in patients with ataxia<\/span><\/p>\n Dysfunction of the cerebrocerebellum<\/b> (lateral <\/span>hemispheres) presents as disturbances in carrying out voluntary, planned movements by the extremities (called appendicular<\/b> ataxia<\/b>)<\/span><\/p>\n These include: intention tremor, peculiar writing abnormalities (large, unequal letters, irregular underlining); a peculiar pattern of dysarthria (slurred speech, sometimes characterised by explosive variations in voice intensity despite a regular rhythm). Inability to perform rapidly alternating movements, known as dysdiadochokinesia. inability to judge distances or ranges of movement. This is known as dysmetria and is often seen as undershooting, hypometria, or overshooting, hypermetria, the required distance or range to reach a target. This is sometimes seen when a patient is asked to reach out and touch someone’s finger or touch his or her own nose.<\/span><\/p>\n The rebound phenomenon, also known as the loss of the check reflex is also sometimes seen in patients with cerebellar ataxia. <\/span><\/p>\n For example, when a patient is flexing his or her elbow isometrically against a resistance. <\/span><\/p>\n When the resistance is suddenly removed without warning, the patient’s arm may swing up and even strike themselves. With an intact check reflex, the patient will check and activate the opposing triceps to slow and stop the movement.<\/span><\/p>\n Sensory ataxia: T<\/b>his is generally caused by dysfunction of the dorsal columns of the spinal cord, <\/b>because they carry proprioceptive information up to the brain. <\/span><\/p>\n In some cases, the cause of sensory ataxia may instead be dysfunction of the various parts of the brain which receive positional information, including the cerebellum, thalamus, and parietal lobes<\/span><\/p>\n Sensory ataxia presents itself with an unsteady “stamping<\/b>” 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.<\/span><\/p>\n Physicians can find evidence of sensory ataxia during physical examination by having the patient stand with his\/her feet together and eyes shut. In affected patients, this will cause the instability to worsen markedly, producing wide oscillations and possibly a fall. This is called a positive Romberg’s test<\/b>. <\/span><\/p>\n Worsening of the finger-pointing test with the eyes closed is another feature of sensory ataxia. <\/span><\/p>\n Also, when the patient is standing with arms and hands extended toward the physician, if the eyes are closed, the patient’s finger will tend to “fall down” and then be restored to the horizontal extended position by sudden muscular contractions<\/span><\/p>\n Vestibular ataxia:<\/b> In slow-onset, chronic bilateral cases of vestibular dysfunction,<\/b> these characteristic manifestations may be absent, and dysequilibrium may be the sole presentation<\/b>.<\/span><\/p>\n Causes: <\/b><\/span>The three types of ataxia have overlapping causes, and therefore can either coexist or occur in isolation.<\/span><\/p>\n Focal lesions Exogenous substances Radiation poisoning Vitamin B<\/b><\/span>12<\/sub><\/b><\/span> deficiency Hypothyroidism Causes of isolated sensory ataxia Spinal disorders of various types may cause sensory ataxia from the lesioned level below, when they involve the dorsal columns<\/span><\/p>\n Non-hereditary cerebellar degeneration Hereditary ataxias Hereditary disorders causing ataxia include autosomal dominant ones such as spinocerebellar ataxia\u00a0 <\/span>episodic ataxia\u00a0 <\/span>and dentatorubropallidoluysian atrophy , as well as autosomal recessive disorders such as Friedreich’s ataxia\u00a0 <\/span>(sensory and cerebellar, with the former predominating) and Niemann Pick disease\u00a0 <\/span>ataxia-telangiectasia\u00a0 <\/span>(sensory and cerebellar, with the latter predominating), and abetalipoproteinaemia . An example of X-linked ataxic condition is the rare fragile X-associated tremor\/ataxia syndrome.<\/span><\/p>\n Arnold-Chiari malformation <\/b>(congenital ataxia) Wilson’s disease Gluten ataxia Gluten ataxia is defined as sporadic cerebellar ataxia associated with the presence circulating antigliadin antibodies and in the absence of an alternative <\/span>etiology <\/span>for ataxia.<\/span><\/p>\n Gluten ataxia is an immune-mediated disease triggered by the ingestion of gluten in genetically susceptible individuals. Readily available and sensitive markers of gluten ataxia include anti-<\/span>gliadin <\/span>antibodies. <\/span>Immunoglobulin A <\/span>(IgA) deposits against <\/span>transglutaminase 2<\/span> (TG2) in the small bowel and at extraintestinal sites are proving to be additional reliable and perhaps more specific markers of the whole spectrum of gluten sensitivity. <\/span><\/p>\n DIAGNOSIS:<\/b><\/span><\/p>\n
\n<\/b><\/span>Although ataxia is not present with all cerebellar lesions, many conditions affecting the cerebellum do produce ataxia. <\/span><\/p>\n\n
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\n<\/b><\/span>The term sensory ataxia is employed to indicate ataxia due to loss of proprioception, the loss of sensitivity to the positions of joint and body parts. <\/b><\/span><\/p>\n
\n<\/span>The term vestibular ataxia<\/i> 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 <\/b><\/span><\/p>\n
\n<\/b><\/span>Any type of focal lesion of the central nervous system (such as stroke, brain tumour, multiple sclerosis) will cause the type of ataxia corresponding to the site of the lesion: cerebellar if in the cerebellum, sensory if in the dorsal spinal cord (and rarely in the thalamus or parietal lobe), vestibular if in the vestibular system (including the vestibular areas of the cerebral cortex).<\/span><\/p>\n
\n<\/b><\/span>Ethanol which is capable of causing reversible cerebellar and vestibular ataxia. various prescription drugs (e.g. most antiepileptic drugs have cerebellar ataxia as a possible adverse effect), Lithium level over 1.5mEq\/L, cannabis ingestion and various other recreational drugs (e.g. ketamine, PCP or dextromethorphan, benzodiazepines. Exposure to high levels of methylmercury\u00a0 <\/span>through consumption of fish with high mercury concentrations<\/span><\/p>\n
\n<\/b><\/span>Ataxia can be induced as a result of severe acute radiation poisoning with an absorbed dose of more than 30 Grays.<\/span><\/p>\n
\n<\/b><\/span>Vitamin B<\/span>12<\/sub><\/span> deficiency may cause, among several neurological abnormalities, overlapping cerebellar and sensory ataxia <\/span><\/p>\n
\n<\/b><\/span>Symptoms of neurological dysfunction may be the presenting feature in some patients with hypothyroidism. These include reversible cerebellar ataxia, dementia peripheral neuropathy\u00a0 <\/span>psychosis and coma. Most of the neurological complications improve completely after thyroid hormone\u00a0 <\/span>replacement therapy <\/span><\/p>\n
\n<\/b><\/span>Peripheral neuropathies <\/span>may cause generalised or localised sensory ataxia (e.g. a limb only) depending on the extent of the neuropathic involvement. <\/span><\/p>\n
\n<\/b><\/span>Non-hereditary causes of cerebellar degeneration include chronic ethanol abuse, head injury, paraneoplastic cerebellar degeneration, high altitude cerebral oedema, coeliac disease, normal pressure hydrocephalus and cerebellitis.<\/span><\/p>\n
\n<\/b><\/span>Hereditary<\/span> disorders consisting of degeneration of the cerebellum and\/or of the spine; most cases feature both to some extent, and therefore present with overlapping cerebellar and sensory ataxia, even though one is often more evident than the other. <\/span><\/p>\n
\n<\/span>Arnold-Chiari malformation is a malformation of the brain. It consists of a downward displacement of the cerebellar tonsils and the medulla through the foramen magnum , sometimes causing hydrocephalus as a result of obstruction of cerebrospinal fluid outflow.<\/span><\/p>\n
\n<\/b><\/span>Wilson’s disease <\/span>is an <\/span>autosomal <\/span>–<\/span>recessive gene <\/span>disorder whereby an alteration of the ATP7B gene results in an inability to properly excrete <\/span>copper <\/span>from the body. Copper accumulates in the nervous system and liver and can cause ataxia as well as other <\/span>neurological <\/span> and organ impairments.<\/span><\/p>\n
\n<\/b><\/span>Gluten ataxia may be a form of <\/span>gluten sensitivity<\/span>. With gluten ataxia, damage takes place in the cerebellum, Gluten ataxia is the single most common cause of sporadic idiopathic ataxia.<\/span><\/p>\n\n