New clinic offers comprehensive diagnostics and comprehensive, compassionate care
The term ataxia refers to a group of progressive neurological diseases that affect coordination and balance. Ataxias are often characterized by poor coordination of hands and eye movements, speech problems and a wide-based and unsteady gait. Cerebellar ataxias are estimated to affect 150,000 people in the U.S., and by extension more than 4,000 in the state of Michigan. While relatively rare, these chronic and progressive diseases are often disabling, particularly in their later stages. While we have made great advances in our understanding of the genetics underlying many of these conditions, we have yet to identify preventive or curative strategies.
The optimal care of patients with ataxias and other coordination and balance disorders requires a multidisciplinary approach. U-M offers one of the most comprehensive ataxia programs in the country, with care now coordinated through the Multidisciplinary Ataxia Clinic. The clinic was organized by ataxia experts from the U-M Departments of Neurology, Physical Therapy, Social Work, and Speech and Language Pathology.
Arriving at a diagnosis
About 50% of patients referred to U-M with a diagnosis of ataxia don’t actually have the disorder. Other movement disorders can produce balance issues which can be confused with ataxia. Because of our high volume of patients and our dedicated clinic, we have a better understanding of the full range of movement disorders and the expertise to recognize, differentiate and treat them.
After gathering a comprehensive medical history and performing a physical exam, our team may advise genetic testing for patients prior to diagnosis. Genetic testing has the potential to help with both diagnosis and treatment planning. Genetic testing may be all that’s required to confirm a diagnosis, saving patients from undergoing a battery of other tests.
In the event that additional tests are called for, they may include blood work, an MRI of the brain and spine, and an electromyography (EMG) to measure the electrical activity of the patient’s muscles, all of which can be coordinated through the clinic.
Treatment planning
We see patients with a range of balance disorders in the Ataxia Clinic. Common disorders in these categories include:
- Spinocerebellar ataxias (SCA)
- Friedreich's ataxia and other recessive ataxias
- Episodic ataxias
- Multiple system atrophy
- Progressive supranuclear palsy
- Corticobasal degeneration
Many treatment options for these conditions are supportive therapies to improve quality of life, including aggressive physical therapy, speech therapy and occupational therapy. Reversible forms of ataxia can also benefit from medication.
Once we have arrived at a diagnosis, patients seen in the clinic work with a physical therapist who helps improve balance and promote independence. The clinic’s social worker facilitates care planning as symptoms progress, working with patients and caregivers to identify community resources as the need for support increases. A language and speech pathologist sees patients on the day of the visit to provide a comprehensive evaluation and recommendations regarding speech and swallowing difficulties. The availability of these services further enhances the quality of care that can be provided for patients with ataxia and balance disorders.
For patient referrals 24 hours a day, call M-Line at 800-962-3555.