Why so clumsy?

A person who appears to be uncoordinated all the time may be suffering from ataxia, which means muscle incoordination.

MY relative is the most uncoordinated person I know. She cannot walk properly. She stumbles over her own feet sometimes, and she has difficulty walking in a straight line. She is very clumsy. She cannot even wear her clothes properly or button them up correctly. We always tease her, until my mother suggested she might have a medical condition.

Yes, it sounds like your relative might be having ataxia. This is a condition where you lack muscle coordination during voluntary movements due to a disorder in parts of your central nervous system. These include movements that you are consciously engaging in, such as eating or walking, or talking or picking up objects.

The word ataxia comes from the Greek word taxis, which means “without order or incoordination”. Ataxia can affect your hands, fingers, arms, body, legs, speech, and even eye movements and your ability to swallow.

How do I know I have ataxia, and it’s not just a case of ‘being clumsy’ by nature?

It’s best to see a doctor. Ataxia can develop over a long time or it can appear suddenly, depending on the cause.

Usually, the first to go is your balance and coordination. You can’t walk properly, for example, and have a tendency to stumble. You tend to place your feet far apart to compensate for your poor balance.

You may find it difficult to do tasks that require precision, such as writing, or lifting up a spoon to your mouth, or buttoning your shirt.

Even your eye movements may become slow. You find it difficult to look to the right when someone is pointing out something to you. Driving becomes very difficult and dangerous.

You might not even be able to talk properly, and there’s slurring of your speech. It may become difficult to form certain words with your tongue or mouth. You might even experience difficulty in swallowing.

So ataxia is not something to be trifled with.

What causes ataxia?

There are various possible causes. It could run in families. There’s a defect in the gene that makes abnormal proteins. This causes problems in nerve cells, particularly the ones in the cerebellum, a part of the brain involved in coordination and balance. Different gene problems cause different types of ataxia, and specific signs and symptoms to go with it.

For example, Friedreich’s ataxia appears commonly between the ages of five and 15. You’re likely to be in a wheelchair at the age of 15. There’s another type called congenital cerebellar ataxia, which appears if there’s damage to the cerebellum before birth. The infant comes into the world with this damage.

There’s also yet another type called Wilson’s disease, where there’s accumulation of copper in the brain and other organs, which can cause neurological problems such as ataxia.

And then there’s episodic ataxia, also inherited via faulty genes. Instead of being progressive, these types are episodic and very brief, lasting only seconds or minutes. They are triggered by stress or sudden movement, and are usually associated with twitching muscles.

Even within the same family, there can be variations with what a person presents with.

Are all ataxias hereditary then? Does it mean that if my relative gets it, I’m also likely to get it?

Only certain hereditary conditions are passed down. Many types of ataxia are acquired “in nature”. Anything that can affect the cerebellum or spinal cord can cause ataxia.

Examples include:

·Injury to the head or spinal cord, such as in an accident or through a blow to the head. This can cause ataxia to come on very suddenly.

·Stroke affecting the cerebellum, or even a transient ischaemic attack (TIA) where the blood supply the brain is suddenly cut off. This ataxia is transient.

·Cerebral palsy, where the child’s brain is damaged either before, during, or after birth.

·Chickenpox and viruses that affect the brain. Very uncommon, but can happen during the healing stage. It normally resolves itself completely over time.

·Multiple sclerosis, which causes the nerve sheaths to lose their protective myelin cover.

·A tumour growing in the cerebellum.

·Drug reaction caused by certain medications like phenobarbital and sedatives.

·Poisoning by lead or heavy metals and solvents such as paint thinners.

·Alcohol.

Is there any cure for ataxia?

Treat the cause, and the ataxia will go. However, some ataxias do not resolve. So you can only adapt and mould your life to live with it. You can use canes or walkers for walking, modified utensils for eating, and communication devices for speaking.

> Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.