Ataxia describes a lack of coordination while performing voluntary movements. It may appear as clumsiness, inaccuracy, or instability. Movements are not smooth and may appear disjointed or jerky.
Ataxia may affect any part of the body. When it affects the arms and hands, it may cause tremor due to over-correction of inaccurate movements, past-pointing when an attempted reach overshoots the target, and poor performance of regular, repeated movements, such as hand clapping. When ataxia affects mechanisms of walking, there will be instability with a tendency to fall. As a result, the child usually adopts a wide-based gait, with the feet spread further apart than the hips. This is done in an attempt to compensate for the instability. The gait may appear "drunken." Balance may also be affected; the child may fall spontaneously or be unable to compensate for variations in the ground or a mild push from the side. When ataxia affects speech, it leads to "scanning" speech. In this form of speech, the voice is relatively monotone, often with a breathy sound accompanied by unusual accelerations or pauses between syllables. When ataxia affects the eyes, rapid shifts of gaze to look at a particular object often miss. On careful examination, the eyes may be observed to overshoot or undershoot their mark, with "catch-up" movements.
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Section Author: Terence Sanger, MD PhD
Scientific Reviewers: Leon Dure, MD, Associate Professor of Pediatrics and Neurology, The University of Alabama at Birmingham; Marjorie A Garvey, MD, Pediatrics and Developmental Neuropsychiatry Branch, NIMH, Human Motor Control Section, NINDS; Jonathan W. Mink, MD PhD, Associate Professor of Neurology, Neurobiology & Anatomy, and Pediatrics Chief, Child Neurology, University of Rochester Medical Center, Rochester, New York
Editor: Joy B. Leffler, NASW, AMIA