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Ataxia, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Inability to perform coordinated movements

  • Caused by a disorder of the cerebellum or its connections:

    • Ipsilateral signs with lateral cerebellar lesions

    • Truncal ataxia with midline lesio...

Diagnosis

Signs and Symptoms

  • Gait disturbance:

    • Ataxia often presents with unsteady gait

    • Initial sense of insecurity while walking

    • Problems with special skills (bicycling, skiing, climbing)

    • Sense of imbalan...

Treatment

Pre-Hospital

  • Acute onset of ataxia may be due to stroke or hemorrhage

  • Deterioration in mental status may warrant field endotracheal intubation

Initial Stabilization/Therapy

  • ABCs

  • IV access

  • Suppleme...

Follow-Up

Disposition

Admission Criteria

  • Acute and subacute ataxia, particularly if a benign etiology cannot be established

  • Patients who cannot ambulate safely

  • Admit patients with cerebellar hemorrhage or...

Pearls and Pitfalls

  • Failure to distinguish true ataxia from other causes of gait instability

  • Failure to note trauma in intoxicated patients

  • Failure to realize the limitations of CT scan in evaluating th...

Additional Reading

  • Friday  JH. Ataxia. In: Fleisher  GR, Ludwig  S, Henretig  FM, et al., eds. Textbook of Pediatric Emergency Medicine. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; ...

Codes

ICD9

  • 334.2 Primary cerebellar degeneration

  • 334.3 Other cerebellar ataxia

  • 781.3 Lack of coordination

  • 334.0 Friedreich's ataxia

ICD10

  • G11.1 Early-onset cerebellar ataxia

  • G11.9 Hereditary ataxia, unspecif...

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