The Comprehensive Management of Cerebellar Ataxia in Adults

Purpose of review In this review, we present the multidisciplinary approach to the management of the many neurological, medical, social, and emotional issues facing patients with cerebellar ataxia. Recent findings Our holistic approach to treatment, developed over the past 25 years in the Massachuse...

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Bibliographic Details
Published in:Current treatment options in neurology 2019-03, Vol.21 (3), p.9-9, Article 9
Main Authors: Stephen, Christopher D., Brizzi, Kate T., Bouffard, Marc A., Gomery, Pablo, Sullivan, Stacey L., Mello, Julie, MacLean, Julie, Schmahmann, Jeremy D.
Format: Article
Language:English
Subjects:
Critical Care Medicine
Diabetes
Family Medicine
General Practice
Intensive
Internal Medicine
Medicine
Medicine & Public Health
Movement Disorders (A Videnovich
Neurology
Ophthalmology
Section Editor
Topical Collection on Movement Disorders
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Summary:Purpose of review In this review, we present the multidisciplinary approach to the management of the many neurological, medical, social, and emotional issues facing patients with cerebellar ataxia. Recent findings Our holistic approach to treatment, developed over the past 25 years in the Massachusetts General Hospital Ataxia Unit, is centered on the compassionate care of the patient and their family, empowering them through engagement, and including the families as partners in the healing process. We present the management of ataxia in adults, beginning with establishing an accurate diagnosis, followed by treatment of the multiple symptoms seen in cerebellar disorders, with a view to maximizing quality of life and effectively living with the consequences of ataxia. We discuss the importance of a multidisciplinary approach to the management of ataxia, including medical and non-medical management and the evidence base that supports these interventions. We address the pharmacological treatment of ataxia, tremor, and other associated movement disorders; ophthalmological symptoms; bowel, bladder, and sexual symptoms; orthostatic hypotension; psychiatric and cognitive symptoms; neuromodulation, including deep brain stimulation; rehabilitation including physical therapy, occupational therapy and speech and language pathology and, as necessary, involving urology, psychiatry, and pain medicine. We discuss the role of palliative care in late-stage disease. Summary The management of adults with ataxia is complex and a team-based approach is essential.
ISSN:1092-8480
1534-3138
DOI:10.1007/s11940-019-0549-2