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Sensory ataxia is a loss of balance associated with disruptions in sensory input and processing. It can be an acquired or congenital condition that typically onsets slowly over time. This condition can be progressive in nature, growing worse as the patient ages, especially if it is not treated. The best options for managing it depend on the root cause and any therapies the patient might currently be using.
In patients with sensory ataxia, peripheral neuropathy is common. The patient doesn’t get input from the peripheral nervous system, which can make it difficult to balance and coordinate movements. With the eyes open to see, coordinated movements like picking an object up or balancing while standing are possible, because the patient’s vision can make up for lack of physical sensations. When the eyes are covered or obscured, the patient has trouble balancing.
A classic warning sign of sensory ataxia can be seen when patients have trouble while dressing or undressing because their vision is obscured as they pull garments over their heads. Likewise, patients might notice that they sway or feel dizzy when leaning over the sink to wash their faces, or in the shower, because they close their eyes to keep soap out of them. In the dark, people may have trouble walking and performing tasks they could do before, like opening a door, because they no longer know precisely where their limbs are in space. Sensory input provides important feedback for coordinating movements and patients may not be aware of this until they lose sensation.
Another sign of sensory ataxia can be seen when a patient is asked to stand with the arms outstretched and the eyes closed. The arms will tend to shake and wander, rather than staying fixed in space. Patients can also have trouble with the Romberg test, where they are asked to stand and balance with closed eyes. They don’t have enough sensory information to retain an upright position in space, even though their brains may be functioning normally and they could balance if they could see.
Treating peripheral neuropathy can help address sensory ataxia. This might include using medications, nerve stimulation, or physical therapy, especially if the patient has a condition like epilepsy that might be contributing to the problem. Occupational therapy can be helpful for those patients having trouble performing everyday tasks. Lifestyle adjustments can also help, such as using nightlights so people are less likely to stumble when navigating the house at night. A full neurological workup may be recommended to check for underlying issues in the brain that may require attention.
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