When you turn your head suddenly, you lose coordination. Brain dysfunction

Each person during his life performs a huge number of very diverse movements and actions. This execution always takes place in a coordinated and organized manner due to the fact that the person has well-developed coordination of movements. If certain changes occur in our central nervous system, it can negatively affect our ability to coordinate our movements. A disorder in the coordination of movements, when they become disordered, disordered and uncontrollable, is called ataxia.

Classification of ataxias

In modern medicine there is one classification of this disorder in the field of motor skills. Ataxia is classified as:

sensitive;
cerebellar;
cortical;
vestibular.

This classification is based on the causes of impaired coordination of movements.

Sensitive ataxia

Impaired coordination of movements occurs if the posterior columns or posterior nerves, as well as the cortex of the parietal lobe of the brain or peripheral nodes are damaged. In this case, most often a person feels certain ailments in the lower extremities.

Such a lack of coordination of movement can manifest itself either in one leg or in both legs at once. In this case, a person gets the impression that he is walking on cotton wool or something very soft. To reduce the sensation of such ataxia, you need to constantly look at your feet.

Cerebellar ataxia

Occurs when there is a disorder of the cerebellum. If one hemisphere of the cerebellum is affected, then the person may lean, even fall, towards this hemisphere. If the lesion affects the cerebellar vermis, then the person can fall in any direction.

People with this disease are unable to stand for a long time with their legs together and their arms extended forward; they begin to fall. In this case, the patient experiences staggering when walking with legs wide apart, and speech also noticeably slows down.

Vestibular ataxia

This type of ataxia occurs with lesions. The main manifestation of this lack of coordination of movement is severe dizziness, which, moreover, intensifies with slight turns of the head. Nausea, vomiting, and inability to take several steps in a straight line may occur.

Cortical ataxia

If a person has damage to the frontal or temporo-occipital lobe of the brain, then cortical ataxia occurs. Loss of coordination when walking occurs in the direction opposite to the affected hemisphere. The person may experience disturbances in the sense of smell or the grasping reflex. The symptoms are similar to those of cerebellar ataxia.

It is worth noting that impaired coordination of movements occurs as a consequence of any disease that you have ever suffered. Therefore, treatment will also be aimed at this very disease. The reasons for poor coordination can be various depletions of the body, brain injuries, and much more.

Whatever type of this disorder you encounter, you should immediately consult a doctor. You will be prescribed a course of preventive and rehabilitation exercises, massages and much more. Know that timely contact with a specialist will preserve your health and well-being.

At first, control occurs due to active static fixation of these organs, then due to short-term physical impulses directed at a certain moment to the desired muscle.

At the final stages of coordination development, inertial movements are used. In an already established dynamically stable movement, balancing of all inertial movements occurs automatically, without producing additional correction impulses.

Coordination of movements is given to a person so that he can perform precise movements and control them. If there is a lack of coordination, this indicates changes occurring in the central nervous system.

Our central nervous system is a complex, interconnected formation of nerve cells located in the spinal cord and brain.

When we want to make any movement, the brain sends a signal, and in response to it, the limbs, torso or other parts of the body begin to move. If the central nervous system does not work coherently, if deviations occur in it, the signal does not reach the target or is transmitted in a distorted form.

Causes of impaired coordination of movements

There are many reasons for impaired movement coordination. These include the following factors:

exposure to alcohol, narcotic and other toxic substances;
brain injuries;
sclerotic changes;
muscle dystrophy;
Parkinson's disease;
ischemic stroke;
catalepsy is a rare phenomenon in which the muscles weaken due to an explosion of emotions, say, anger or delight.

Lack of coordination is considered a dangerous deviation for a person, because in such a state it costs nothing to get injured. This often accompanies old age, as well as previous neurological diseases, a striking example of which in this case is stroke.

Impaired coordination of movements also occurs in diseases of the musculoskeletal system (poor muscle coordination, weakness in the muscles of the lower extremities, etc.) If you look at such a patient, it becomes noticeable that it is difficult for him to maintain an upright position and walk.

In addition, impaired coordination of movements can be a symptom of the following diseases:

Signs of impaired coordination of movements

People with such ailments move uncertainly, their movements show laxity, too much amplitude, and inconsistency. Having tried to outline an imaginary circle in the air, a person is faced with a problem - instead of a circle, he gets a broken line, a zigzag.

Another test for incoordination is to ask the patient to touch the tip of the nose, which also fails.

Looking at the patient’s handwriting, you will also be convinced that his muscle control is not all right, since letters and lines creep on top of each other, becoming uneven and sloppy.

Symptoms of impaired coordination of movements

The following symptoms of impaired coordination of movements exist:

Shaky movements

this symptom occurs when the muscles of the body, especially the limbs, weaken. The patient's movements become uncoordinated. When walking, he sways a lot, his steps become abrupt and have different lengths.

Tremor

Tremor - shaking of the hands or head. There is a strong and almost imperceptible tremor. In some patients it begins only during movement, in others - only when they are motionless. With severe anxiety, the tremor increases; shaky, uneven movements. When the muscles of the body are weakened, the limbs do not receive a sufficient basis for movement. The patient walks unevenly, intermittently, the steps are of different lengths, and he staggers.

Ataxia

Ataxia is caused by damage to the frontal parts of the brain, cerebellum, and nerve fibers transmitting signals through the channels of the spinal cord and brain. Doctors distinguish between static and dynamic ataxia. With static ataxia, a person cannot maintain balance in a standing position; with dynamic ataxia, it is difficult for him to move in a balanced manner.

Motor coordination tests

Unfortunately, many people have poor coordination. If you want to test yourself, we offer you a very simple test.

Test No. 1

To do this, you need to perform the exercise while standing. Try pushing your toes and heels together while your eyes are closed.

Test No. 2

Another option to test your coordination is to sit on a chair and lift your right leg up. Rotate your leg clockwise, and at the same time draw the letter “b” with your right hand, imitating its silhouette in the air, starting from the “tail” of the letter.

Test No. 3

Try placing your hand on your stomach and stroking it clockwise while tapping your head with the other hand. If, as a result of the test, you completed all the tasks the first time, this is an excellent result. We congratulate you! You have good coordination. But if you were not able to immediately perfectly perform all of the above, do not despair!

Exercises to develop motor coordination

The greatest effect can be achieved if coordination is developed from 6-10 years of age. During this period, the child develops, learns dexterity, speed, accuracy, coordinating his movements in games and exercises.

You can develop coordination of movements with the help of special exercises and training, thanks to Pilates, breaking exercises, as well as with the help of other sports that involve various objects (fitball, dumbbells, jump ropes, medicine balls, sticks, etc.)

Coordination exercises can be done anywhere, for example:

In transport

Do not look for free space, but rather stand and do the exercise. Place your feet shoulder-width apart and try not to hold on to the car's handrails while driving. Perform the exercise carefully so that when you stop abruptly, you do not roll to the floor. Well, let the surprised passengers look at you, but soon you will have excellent coordination!

On a stepladder

Holding the ladder with your hands, go up and down. Once you have rehearsed a few ascents and descents, try doing the same exercise, but without using your hands.

Standing on the floor

You will need an apple in each hand. Imagine that you are in a circus ring and juggling. Your task is to throw apples up and at the same time catch them again. You can make the task more difficult by throwing both apples at the same time. As soon as you get the hang of throwing both apples and catching them with the hand that made the throw, proceed to a more complicated version of the exercise. Perform the same movement, but catch the apple with the other hand, placing your hands crosswise.

On a narrow curb

On a narrow curb you can perform a number of exercises that coordinate your movements. Find a narrow curb and walk along it every day until your gait becomes like that of a cat - graceful, smooth and beautiful.

There are a number of coordination exercises that can be done daily:

do somersaults forward and backward;
running, jumping and various relay races with a skipping rope;
combining several exercises into one, for example, somersaulting and catching a ball;
hitting the target with the ball.

Using the ball: hitting the wall and catching it, hitting the ball on the floor, throwing the ball from the chest to a partner in different directions (in this exercise it is necessary not only to throw the ball, but also to catch it in the same unpredictable directions).

Which doctors should you contact if there is a lack of coordination of movements:

Questions and answers on the topic “Coordination of movements”

Question: Tell me, if I remove my meningioma, will my coordination improve? Or is it cervical matters, where I also have a problem with hernias?

Question: Good afternoon. I can't figure out what it is. Sometimes coordination suddenly disappears, then it appears and everything is fine. I'm not falling. I am physically strong, I go in for sports.

Question: Hello! I have problems with coordination of movements. I constantly hit door frames, I just can’t “fit” into the door (it’s like I’m skidding). It’s difficult to stand on public transport, I’m constantly dangling like a rag in the wind, falling over every bump. Could this be a consequence of osteochondrosis (I have had it for 4 years, in the cervical spine), or is it just a bad vestibular system and inattention?

Question: Hello. I have been sick for about 2 years (I am 25 years old). Loss of coordination of movement, dizziness when walking. Sitting, lying down, turning my head, I don’t feel dizzy. There was a strange sensation in my head, a spasm of blood vessels, at such moments it seemed to me that I might lose consciousness. There was a feeling of fear. Please answer me, what causes dizziness and how to treat it? Are there enough grounds to say that the cause is osteochondrosis of the cervical spine.

Question: Good afternoon What tests are there for motor coordination?

Question: Hello! How to improve coordination of movements? Thank you.

Loss of coordination (ataxia)

Loss of coordination - ataxia, that is, lack of coordination of movements, which is not associated with muscle weakness. First of all, this concerns the coordination of movement of the upper and lower extremities. Ataxia is not an independent disease, but develops secondary to other diseases of the nervous system.

Causes

There are many different causes of ataxia. These may be diseases of the brain and vestibular apparatus. Thus, ataxia can develop in acute cerebrovascular accident, brain tumors, traumatic brain injury, hydrocephalus, demyelinating diseases and other brain pathologies.

As for diseases of the vestibular apparatus, the cause of ataxia can be: labyrinthitis, vestibular neuronitis, vestibular nerve neuroma and others.

Ataxia also occurs when the body is poisoned, for example, with sleeping pills and potent drugs. Some hereditary diseases and vitamin B12 deficiency can also cause problems with motor coordination.

Symptoms of incoordination

With ataxia, there is unsteadiness in a standing position. In a state of ataxia, a person sways from side to side and may even fall. The gait is disturbed, it becomes uncertain and shaky. In this condition, a person’s coordination is impaired when performing precise movements, for example, it becomes difficult for a person to bring a mug of tea to his mouth. There is a disturbance in speech and breathing rhythm.

With ataxia, symptoms may also occur that are associated with damage to parts of the brain, namely dizziness, headache, nausea and vomiting.

Diagnostics

Diagnosis of ataxia includes the following procedures:

analysis of complaints and collection of medical history;
neurological examination of the patient, in particular assessment of his gait, coordination of movements, muscle tone and strength in the limbs;
examination by an otolaryngologist – balance test and ear examination;
conducting a toxicological analysis to look for signs of poisoning of the body;
blood test for signs of inflammation;
determination of the concentration of vitamin B12 in the blood;
electroencephalography;
computed and magnetic resonance imaging;
magnetic resonance angiography;
consultation with a neurosurgeon (if necessary).

Classification

The following forms of ataxia are distinguished:

Static ataxia is a lack of coordination when standing. In this case, the patient has a tendency to fall backwards and to the sides.
Statolocomotor ataxia - expressed in unsteady gait and swaying when walking.
Kinetic ataxia is a lack of coordination of movements when performing precise actions.
Sensitive ataxia is associated with damage to the pathways that carry nerve impulses.
The vestibular form of ataxia is associated with lesions of the vestibular apparatus, which helps maintain a person’s balance.
The cortical form of ataxia is associated with lesions of the cerebral cortex, which is responsible for voluntary movements.

Patient Actions

If you have problems with coordination of movements, you should consult a doctor to find out the cause of the condition.

Treatment of coordination problems

Treatment of ataxia should be aimed at eliminating the underlying disease. In some cases, treatment may be surgical. For example, surgical intervention is used for tumors, cerebral hemorrhages, ulcers, decreased pressure in the posterior cranial fossa (with Arnold-Chiari anomaly), as well as if it is necessary to create an outflow for cerebrospinal fluid (for example, with hydrocephalus).

Treatment of ataxia also involves normalizing blood pressure, as well as improving cerebral circulation through medications (cinnarizine). In case of infectious lesions of the brain, antibiotic therapy is necessary. For demyelinating diseases, it is advisable to prescribe hormonal drugs.

Complications

A neurological defect (unsteadiness of gait, lack of coordination of movements) can persist for a long period (possibly for life). Ataxia leads to disruption of social and labor adaptation.

Preventing coordination problems

Prevention of ataxia comes down to the following measures:

timely treatment of infectious diseases;
healthy lifestyle;
rational balanced nutrition;
timely consultation with a doctor if various health problems arise;
blood pressure control.

Associated symptoms:

Therapy:

The information published on the site is for informational purposes only. Described methods of diagnosis, treatment, traditional medicine recipes, etc. It is not recommended to use it yourself. Be sure to consult a specialist so as not to harm your health!

Impaired movement coordination

Impaired coordination of movement (ataxia) is a symptom of a certain pathological process that provokes disruption of the central nervous system, in particular the brain, less often than other systems of the body. To eliminate the symptom, a comprehensive diagnosis and elimination of the root cause is required. Self-medication is unacceptable, as it can lead to the development of serious complications, including disability and death.

Etiology

Impaired coordination of movements in children or adults can be caused by the following etiological factors:

brain or spinal cord injuries;
stroke;
parkinsonism;
autoimmune diseases;
physical exhaustion of the body;
excessive consumption of alcoholic beverages;
exposure to narcotic substances;
muscle dystrophy;
catalepsy is a pathological process that is characterized by weakening of muscles as a result of severe emotional shock, stress, or an attack of anger;
sclerotic changes;
age-related changes in older people.

In addition, impaired coordination of movements can also be observed in diseases of the musculoskeletal system.

Symptoms

Common features include the following:

unsteadiness of gait and standing;
dizziness;
clarity and coherence of movements are lost;
trembling of the limbs and head is noted;
movements become uncertain;
feeling of weakness in the arms and legs.

Depending on the main factor of the movement disorder, clinical manifestations may be supplemented by specific signs that are characteristic of a particular disease.

In pathologies that affect the brain and central nervous system, the following additional signs may be observed:

headaches for no apparent reason;
dizziness;
noise in ears;
feeling of weakness in the legs;
sleep cycle disturbance;
nausea, possibly with bouts of vomiting;
unstable blood pressure;
change in breathing rhythm;
disorders of a psychoneurological nature - visual or auditory hallucinations, delusions, impaired clarity of consciousness.

Due to the above violations, a person may fall. Depending on the extent of the injuries, the patient may also experience impaired consciousness.

With physical exhaustion of the body, the following clinical picture may be observed:

In diseases of the musculoskeletal system, the general clinical picture may be supplemented by pain in the affected joints, impaired motor function, and limited movement.

Regardless of what symptoms are present, if this symptom is present, you should immediately consult a doctor.

Diagnostics

First of all, the doctor clarifies the complaints, medical history, and life of the patient, after which he conducts a thorough objective examination of the patient. To determine the root cause factor, the following laboratory and instrumental diagnostic methods are used:

general blood and urine analysis;
detailed biochemical blood test;
ultrasound examination of internal organs.

Depending on the current clinical manifestations, the diagnostic program may be adjusted. The doctor describes treatment tactics only after making an accurate diagnosis, which is established on the basis of the examination results.

Treatment

Elimination of this disorder is carried out comprehensively. Basic therapy will depend on the underlying factor. Drug treatment may include taking the following drugs:

neuroprotectors;
nootropics;
activators of cellular metabolism.

In addition to drug treatment, a physical exercise program is required. Gymnastics for problems with balance and coordination can speed up the process of recovery and rehabilitation.

As for prevention, in this case there are no specific recommendations, since this is not a separate disease, but a nonspecific symptom. At the first symptoms, you should consult a doctor and not self-medicate.

“Impaired motor coordination” is observed in diseases:

Alcohol intoxication is a complex of behavioral disorders, physiological and psychological reactions that usually begin to progress after drinking alcohol in large doses. The main reason is the negative impact on organs and systems of ethanol and its breakdown products, which cannot leave the body for a long time. This pathological condition is manifested by impaired coordination of movements, euphoria, impaired orientation in space, and loss of attentiveness. In severe cases, intoxication can lead to coma.

Angioma (red mole) is a benign tumor that consists of lymphatic and blood vessels. Most often, the formation is formed on the face, skin of the torso and limbs, and on internal organs. Sometimes its appearance and development may be accompanied by bleeding. In most clinical situations, this pathology is congenital and is diagnosed in newborns in the first few days of their life.

A cerebral aneurysm (also called an intracranial aneurysm) appears as a small abnormal formation in the blood vessels of the brain. This compaction can actively increase due to filling with blood. Until it ruptures, such a bulge is not dangerous or harmful. It only exerts slight pressure on the organ tissue.

Antiphospholipid syndrome is a disease that includes a whole complex of symptoms related to a disorder of phospholipid metabolism. The essence of the pathology is that the human body mistakes phospholipids for foreign bodies, against which it produces specific antibodies.

Arteriovenous malformation (syn. AVM) is a congenital (in some cases acquired) pathological process in which the formation of a tangle of dilated vessels of the spinal cord or brain is noted. People rarely suffer from malformation - the pathology occurs in two people per 100 thousand of the population.

Alzheimer's disease is a degenerative brain disease that manifests itself in the form of a progressive decline in intelligence. Alzheimer's disease, the symptoms of which were first identified by Alois Alzheimer, a German psychiatrist, is one of the most common forms of dementia (acquired dementia).

Niemann-Pick disease is a hereditary disease in which fat accumulates in various organs, most often in the liver, spleen, brain and lymph nodes. This disease has several clinical forms, each of which has its own prognosis. There is no specific treatment, high risk of death. Niemann-Pick disease affects both males and females equally.

Parkinson's disease, also defined as shaking palsy, is a long-term progressive condition accompanied by impaired motor function and a number of disorders. Parkinson's disease, the symptoms of which gradually worsen over time, develops due to the death of the corresponding nerve cells in the brain that are responsible for controlling movement. The disease is subject to certain adjustments in symptoms, can last for many years and is incurable.

Pompe disease (syn. glycogenosis type 2, acid alpha-glucosidase deficiency, generalized glycogenosis) is a rare hereditary disease that causes damage to muscle and nerve cells throughout the body. It is noteworthy that the later the disease develops, the more favorable the prognosis.

Fabry's disease (syn. hereditary dystonic lipidosis, ceramide trihexosidosis, diffuse universal angiokeratoma, Andersen's disease) is a hereditary disease that causes metabolic problems when glycosphingolipids accumulate in the tissues of the human body. It occurs equally in men and women.

Chickenpox (also known as chickenpox) is a highly contagious infectious disease that primarily affects children. Chickenpox, the symptoms of which are characterized primarily by the appearance of a blistering rash, however, can also be diagnosed in adults, especially if the appropriate vaccinations have not been made.

Hypothermia is a pathological decrease in central body temperature in men or women (including a newborn) to a level below 35 degrees. The condition is extremely dangerous for a person’s life (we are no longer talking about complications): if the person is not provided with medical assistance, death occurs.

Hypotrophy in children is a pathological disorder of weight gain, which affects overall development (physical and psychological). There is also a decrease in skin turgor and growth retardation. As medical practice shows, this disease occurs in children under 2 years of age.

Disseminated intravascular coagulation or disseminated intravascular coagulation (DIC) is a disorder of the ability of blood to clot, which develops against the background of excessive influence of pathological factors. The disease entails the formation of blood clots and damage to internal organs and tissues. This disorder cannot be independent; moreover, the more severe the underlying illness, the more pronounced this syndrome is. In addition, even if the underlying disease affects only one organ, then with the development of thrombohemorrhagic syndrome, the involvement of other organs and systems in the pathological process is inevitable.

Diabetic neuropathy is a consequence of ignoring symptoms or lack of treatment to control diabetes. There are several predisposing factors for the appearance of such a disorder against the background of the underlying disease. The main ones are addiction to bad habits and high blood pressure.

Speaking about dyslexia, it is important to note that there is no generally accepted definition of this disease today, however, the International Dyslexia Association still gives its own decoding. Thus, dyslexia, the symptoms of which are the inability to correctly and efficiently recognize words, perform decoding and master spelling skills, is a specific type of learning disorder. This type of difficulty is neurological in nature and is associated with the inferiority of the phonological components of the language.

Discirculatory encephalopathy is a disease characterized by impaired functioning of the brain due to improper blood circulation through its vessels. Pathological changes affect both the cortex and subcortical structures of the brain. The disease is accompanied by impaired motor and mental functions, combined with emotional disorders.

Dorsopathy – does not act as an independent disease, i.e. is a generalized term that combines a group of pathological conditions that affect the spine and nearby anatomical structures. These include ligaments and blood vessels, nerve roots and fibers, as well as muscles.

Delayed psycho-speech development is a disease that is characterized by a disruption in the rate of mental development of a child. In most cases, this disease is caused by abnormalities in the development of the nervous system, in particular the brain. The latter may be due to a number of etiological factors, and the incorrect lifestyle of parents is no exception. According to the International Classification of Diseases, Tenth Revision (ICD-10), this pathology is assigned code F80. Whether it is possible to completely cure this disease, only a doctor can say after examining the patient. The sooner this disorder is diagnosed, the greater the child’s chances of recovery.

Ischemic stroke is an acute type of cerebral circulatory disorder that occurs due to insufficient supply of blood to a certain area of the brain or to the complete cessation of this process; in addition, it causes damage to brain tissue in combination with its functions. Ischemic stroke, the symptoms of which, as well as the disease itself, are most often noted among the most common types of cerebrovascular diseases, is the cause of subsequent disability and often death.

Ischemia is a pathological condition that occurs when there is a sharp weakening of blood circulation in a certain area of an organ, or in the entire organ. Pathology develops due to decreased blood flow. A lack of blood circulation causes metabolic disorders and also leads to disruption of the functioning of certain organs. It is worth noting that all tissues and organs in the human body have different sensitivity to lack of blood supply. Less susceptible are cartilage and bone structures. More vulnerable are the brain and heart.

Labyrinthitis is an inflammatory disease that affects the inner ear. It begins to progress due to the penetration of infectious agents into the organ or due to injury. In medicine, this disease is also called internal otitis. It is characterized by the development of vestibular disorders (dizziness, loss of coordination), as well as damage to the auditory organs.

Leukodystrophy is a pathology of neurodegenerative origin, of which there are more than sixty varieties. The disease is characterized by a metabolic disorder, which leads to the accumulation of specific components in the brain or spinal cord that destroy a substance such as myelin.

Lethargic encephalitis (syn. zombie disease, epidemic encephalitis, Economo's sleepy encephalitis) is a viral disease, the characteristic features of which are pathological drowsiness, combined with oculomotor disorders or other neurological symptoms.

Minor chorea (Sydenham's chorea) is a disease of rheumatic etiology, the development of which is based on damage to the subcortical nodes of the brain. A characteristic symptom of the development of pathology in humans is impaired motor activity. The disease mainly affects young children. Girls get sick more often than boys. The average duration of the disease is from three to six months.

Meningioma is a tumor that forms in the spinal cord or brain from the arachnoid membranes (arachnoid). It can have either a spherical or horseshoe shape, and very often connects with the dura maters of the spinal cord or brain, and the growth center in it is predominantly not one, but several.

Meningoencephalitis is a pathological process that affects the brain and its membranes. Most often, the disease is a complication of encephalitis and meningitis. If not treated in time, this complication can have an unfavorable prognosis with a fatal outcome. The symptoms of the disease are different for each person, since it all depends on the degree of damage to the central nervous system.

Migraine is a fairly common neurological disease accompanied by severe paroxysmal headaches. Migraine, the symptoms of which are pain, concentrated on one side of the head mainly in the area of the eyes, temples and forehead, nausea, and in some cases vomiting, occurs without reference to brain tumors, stroke and serious head injuries, although and may indicate the relevance of the development of certain pathologies.

Pituitary microadenoma is a benign formation that does not exceed 10 mm in size; it does not always manifest itself symptomatically. This pathological process has no restrictions on age and gender, however, according to statistics, it most often occurs in women of childbearing age. Clinicians suggest that this may be due to changes in hormonal levels during pregnancy.

Microangiopathy is a pathological condition characterized by damage to small blood vessels in the human body. Capillaries are the first to be destroyed. Most often, this pathology is not an independent nosological entity, but acts as a symptom of other diseases that progress in the human body.

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Symptoms and treatment of human diseases

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Ataxia

Ataxia (from the Greek ataxia - disorder) - a disorder of coordination of movements; a very common motor disorder. Strength in the limbs is slightly reduced or completely preserved. Movements become inaccurate, awkward, their continuity and consistency are disrupted, balance in a standing position and when walking is disturbed. Static ataxia is a violation of balance in a standing position, dynamic ataxia is a violation of coordination when moving. Diagnosis of ataxia includes a neurological examination, EEG, EMG, MRI of the brain, and if the hereditary nature of the disease is suspected, DNA analysis. Therapy and prognosis for the development of ataxia depend on the cause of its occurrence.

Ataxia

Normal coordination of movements is possible only with highly automated and cooperative activity of a number of parts of the central nervous system - conductors of deep muscle sensitivity, the vestibular apparatus, the cortex of the temporal and frontal regions and the cerebellum - the central organ of coordination of movements.

Classification of ataxias

In clinical practice, there are several types of ataxia:

sensitive (or posterior columnar) ataxia - a violation of the conductors of deep muscle sensitivity;
cerebellar ataxia - damage to the cerebellum;
vestibular ataxia - damage to the vestibular apparatus;
cortical ataxia - damage to the cortex of the temporo-occipital or frontal region.

Symptoms of ataxia

The occurrence of sensitive ataxia is caused by damage to the posterior columns (gaulle and Burdach bundles), less often the posterior nerves, peripheral nodes, the parietal lobe of the brain, the visual thalamus (funicular myelosis, tabes dorsalis, tumors, vascular disorders). It may manifest itself in all limbs, or in one leg or arm. The most significant phenomena are sensory ataxia, which occurs as a result of a disorder of joint-muscular sensation in the lower extremities. The patient is unsteady, when walking he bends his legs excessively at the hip and knee joints, and steps too hard on the floor (stamping gait). Often there is a feeling of walking on cotton wool or carpet. Patients try to compensate for the disorder of motor functions with the help of vision - when walking, they constantly look at their feet. This can significantly reduce the manifestations of ataxia, and closing the eyes, on the contrary, aggravates them. Severe lesions of the posterior columns practically make it impossible to stand and walk.

Cerebellar ataxia is a consequence of damage to the cerebellar vermis, its hemispheres and peduncles. In the Romberg position and when walking, the patient falls (even to the point of falling) towards the affected cerebellar hemisphere. If the cerebellar vermis is damaged, it is possible to fall to any side or backward. The patient staggers when walking and places his legs wide. The flanking gait is severely impaired. Movements are sweeping, slow and awkward (more so on the part of the affected cerebellar hemisphere). Coordination disorder is almost invariable during visual control (open and closed eyes). There is a disturbance in speech - it slows down, becomes stretched, jerky, and often chanted. Handwriting becomes splayed, uneven, and macrography is observed. There may be a decrease in muscle tone (more on the affected side), as well as a violation of tendon reflexes. Cerebellar ataxia can be a symptom of encephalitis of various etiologies, multiple sclerosis, malignant neoplasm, vascular lesion in the brainstem or cerebellum.

Vestibular ataxia develops when one of the sections of the vestibular apparatus is damaged - the labyrinth, vestibular nerve, nuclei in the brain stem and the cortical center in the temporal lobe of the brain. The main symptom of vestibular ataxia is systemic dizziness (it seems to the patient that all objects around him are moving in the same direction), dizziness intensifies when turning the head. In this regard, the patient staggers randomly or falls, and makes head movements with noticeable caution. In addition, vestibular ataxia is characterized by nausea, vomiting and horizontal nystagmus. Vestibular ataxia is observed in brainstem encephalitis, ear diseases, tumors of the fourth ventricle of the brain, as well as in Meniere's syndrome.

The development of cortical ataxia (frontal) is caused by damage to the frontal lobe of the brain caused by dysfunction of the fronto-pontocerebellar system. In frontal ataxia, the leg contralateral to the affected cerebellar hemisphere is most affected. When walking, there is instability (more so when turning), tilting or leaning to the side ipsilateral to the affected hemisphere. With severe lesions of the frontal lobe, patients cannot walk or stand at all. Vision control has no effect on the severity of walking disorders. Cortical ataxia is also characterized by other symptoms characteristic of damage to the frontal lobe - the grasping reflex, mental changes, and impaired sense of smell. The symptom complex of frontal ataxia is very similar to cerebellar ataxia. The main difference between cerebellar lesions is evidence of hypotonia in the ataxic limb. The causes of frontal ataxia are abscesses, tumors, and cerebrovascular accidents.

Hereditary cerebellar Pierre-Marie ataxia is a hereditary disease of a chronic progressive nature. It is transmitted in an autosomal dominant manner. Its main manifestation is cerebellar ataxia. The pathogen has high penetrance, skipping generations is very rare. A characteristic pathological sign of Pierre-Marie ataxia is cerebellar hypoplasia, less often - atrophy of the inferior olives, the pons (pons). Often these signs are combined with combined degeneration of the spinal systems (the clinical picture resembles Friedreich's spinocerebellar ataxia).

The average age of onset is 35 years when gait disturbance appears. Subsequently, it is accompanied by disturbances in facial expressions, speech and ataxia in the hands. Static ataxia, adiadochokinesis, and dysmetria are observed. Tendon reflexes are increased (to pathological reflexes). Involuntary muscle twitches are possible. Strength in the muscles of the limbs is reduced. Progressive oculomotor disorders are observed - paresis of the abducens nerve, ptosis, convergence insufficiency, less often - Argyll Robertson's symptom, optic nerve atrophy, decreased visual acuity, narrowing of the visual fields. Mental disorders manifest themselves in the form of depression and decreased intelligence.

Familial Friedreich's ataxia is a hereditary disease of a chronic progressive nature. It is transmitted in an autosomal dominant manner. Its main manifestation is mixed sensory-cerebellar ataxia, resulting from combined damage to the spinal systems. Consanguineous marriages are very common among patients' parents. A characteristic pathological sign of Friedreich's ataxia is increasing degeneration of the lateral and posterior columns of the spinal cord (up to the medulla oblongata). Gaulle's bundles are most affected. In addition, the cells of Clark's columns are affected, and along with them the posterior spinocerebellar tract.

The main symptom of Friedreich's ataxia is ataxia, expressed in an uncertain, clumsy gait. The patient walks in a sweeping manner, deviating from the center to the sides and placing his feet wide. Charcot designated this gait as a tabetic-cerebellar gait. As the disease progresses, incoordination spreads to the arms, chest muscles and face. Facial expressions change, speech becomes slow and jerky. Tendon and periosteal reflexes are significantly reduced or absent (primarily on the legs, later on the upper extremities). In most cases, hearing is reduced.

With the development of Friedreich's ataxia, extraneural disorders appear - cardiac lesions and skeletal changes. The ECG shows deformation of the atrial wave, rhythm disturbance. There is paroxysmal pain in the heart, tachycardia, shortness of breath (as a result of physical stress). Skeletal changes are expressed in a characteristic change in the shape of the foot - a tendency to frequent dislocations of the joints, an increase in the arch and extension of the fingers, as well as kyphoscoliosis. Among the endocrine disorders that accompany Friedreich's ataxia are diabetes, hypogonadism, and infantilism.

Ataxia-telangiectasia (Louis-Bar syndrome) is a hereditary disease (phakomatoses group), transmitted in an autosomal recessive manner. Very often accompanied by dysgammaglobulinemia and hypoplasia of the thymus gland. The development of the disease begins in early childhood, when the first ataxic disorders appear. In the future, ataxia progresses and by the age of 10, walking is almost impossible. Louis-Bar syndrome is often accompanied by extrapyramidal symptoms (hyperkinesis of the myoclonic and athetoid type, hypokinesia), mental retardation, and damage to the cranial nerves. There is a tendency to repeated infections (rhinitis, sinusitis, bronchitis, pneumonia), which is primarily due to the insufficiency of the body’s immunological reactions. Due to the deficiency of T-dependent lymphocytes and class A immunoglobulins, there is a high risk of malignant neoplasms.

Complications of ataxia

Tendency to recurrent infectious diseases.
Chronic heart failure.
All types of respiratory failure.

Diagnosis of ataxia

Diagnosis of ataxia is based on identification of diseases in the patient's family and the presence of ataxia. EEG of the brain in Pierre Marie's ataxia and Friedreich's ataxia reveals the following disorders: diffuse delta and theta activity, reduction of the alpha rhythm. In laboratory studies, a disturbance in amino acid metabolism is observed (the concentration of leucine and alanine is reduced, and their excretion in the urine is also reduced). MRI of the brain reveals atrophy of the spinal cord and brain stems, as well as the upper parts of the vermis. Using electromyography, axonal demyelinating damage to the sensory fibers of peripheral nerves is detected.

When differentiating ataxia, it is necessary to take into account the variability of the clinical picture of ataxia. In clinical practice, rudimentary varieties of ataxia and its transitional forms are observed, when the clinical manifestations are similar to the symptoms of familial paraplegia (spastic), neural amyotrophy and multiple sclerosis.

To diagnose hereditary ataxias, direct or indirect DNA diagnostics is necessary. Using molecular genetic methods, ataxia is diagnosed in a patient, after which indirect DNA diagnostics are performed. With its help, the possibility of inheriting the ataxia pathogen by other children in the family is established. It is possible to carry out complex DNA diagnostics; it will require biomaterial from all family members (the child’s biological parents and all other children of this parental couple). In rare cases, prenatal DNA diagnosis is indicated.

Treatment and prognosis of ataxia

Ataxia is treated by a neurologist. It is predominantly symptomatic and should include: restorative therapy (B vitamins, ATP, anticholinesterase drugs); a special set of gymnastic exercises aimed at strengthening muscles and reducing incoordination. With Friedreich's ataxia, taking into account the pathogenesis of the disease, drugs that support mitochondrial functions (succinic acid, riboflavin, coenzyme Q10, vitamin E) can play a large role in treatment.

To treat ataxia-telangiectasia, in addition to the above algorithms, correction of immunodeficiency is necessary. For this purpose, a course of treatment with immunoglobulin is prescribed. Radiation therapy is contraindicated in such cases; in addition, excessive X-ray radiation and prolonged exposure to the sun should be avoided.

The prognosis of genomic hereditary diseases is unfavorable. There is a slow progression of neuropsychiatric disorders. Working capacity in most cases is reduced. However, thanks to symptomatic treatment and prevention of recurrent infectious diseases, injuries and intoxications, patients have the opportunity to live to an old age. For preventive purposes, the birth of children in families where there are patients with hereditary ataxia should be avoided. In addition, it is recommended to exclude the possibility of any related marriages.

Ataxia is a type of movement disorder that occurs in patients after a stroke. This is a collective concept that includes several types of movement coordination disorders. In clinical practice, cerebellar ataxia most often occurs, the cause of which is impaired blood circulation in the cerebellum. According to statistics, cerebellar stroke is not so common - in about 10% of cases.

However, more than half of the episodes of this type of stroke are fatal, and a very high percentage of disability is recorded among survivors.

Ataxia is a disorder of movement coordination and motor skills.

Classification of ataxias

Normally, coordination of movements is regulated by the following parts of the brain:

medulla oblongata and midbrain;
cerebellum;
vestibular apparatus;
frontotemporal cortex of the cerebral hemispheres.

The Gaulle and Burdach bundles pass through the posterior part of the brain stem. They are responsible for deep muscle sensitivity. The main task of the cerebellum is to supplement and coordinate the work of motor centers. Thanks to him, movements become smooth, clear and proportionate. The cerebellar vermis maintains normal muscle tone and balance. Thanks to the coordinated activity of the vestibular nuclei, balance is maintained during movements. The frontal lobe cortex is responsible for voluntary movements.

It is difficult to say which of these departments is the most important in the coordination of movements. All of them are connected by numerous synaptic connections, which ensures normal motor activity. Depending on where the stroke occurred, clinicians distinguish between the following types of motor coordination disorders, or ataxias:

sensitive;
cerebellar;
vestibular;
cortical.

Sensitive ataxia

This type of ataxia develops after a stroke in the posterior columns of the spinal cord, the thalamus. It can occur in both limbs, one arm, or one leg. This type of movement disorder is characterized by loss of proprioceptive sensation. The patient cannot assess the position of his own body parts. A so-called stamping gait is observed - the patient bends his legs excessively and steps very hard on the floor. Often complains of the feeling of walking on a soft carpet. The victim constantly looks at his feet, thus trying to alleviate the pathological symptoms. When closing the eyes, the manifestations of ataxia intensify.

Cerebellar ataxia

Develops after a cerebellar stroke. There is unsteadiness when walking. The patient deviates towards the lesion, and in severe cases falls. If the cerebellar vermis is affected, a fall is possible in any direction and backwards. Walking is unsteady, with legs spread wide apart. Walking with an extended step is impossible or severely impaired. Hand movements are disproportionate and slow. The arm and leg on the affected side are more affected. Speech slows down, becomes drawn out and chanted. Unlike aphasia, where speech disorders are based on the death of neurons in cortical centers, coordination of movements is impaired in patients after a cerebellar stroke. The handwriting changes - the letters become sweeping and large.

Distinctive features of the gait of a patient with ataxia

Vestibular ataxia

Vestibular ataxia occurs when moving, sitting or standing. Symptoms intensify when turning the head, torso, and eyes. The person refuses to perform these movements, replaces them with others, or performs them at a slow pace. Thanks to visual control, it is possible to significantly compensate for coordination disorders. With unilateral lesions of the vestibular nuclei, unsteadiness and deviations of the body occur in the direction of the lesion. Movement disorders are especially noticeable when walking with eyes closed. Vestibular ataxia is accompanied by severe autonomic disorders - nausea, dizziness, nystagmus.

Cortical ataxia

A specific impairment of motor coordination that develops in patients after a stroke in the frontal lobe of the cerebral hemispheres. Mostly in such situations the legs suffer. Hands are not involved. The patient's gait is uncertain, shaky, in one line. The body leans back. The patient cannot stand or walk, although he has no signs of paresis or paralysis.

Clinical manifestations of cortical ataxia

Diagnostic tests

Diagnosis of motor coordination disorders in patients after a stroke is based on the following points:

patient complaints;
inspection data;
diagnostic test results;
data from the results of additional research methods.

Coordination tests allow you to determine the type of ataxia and determine the location of the stroke.

Static ataxia is determined first. The patient is placed in the Romberg position - legs together, arms forward, eyes closed. The patient's stability is assessed. After the usual Romberg test, a complicated one is performed - you are asked to stretch your arms in front of you at shoulder level, spread your fingers to the sides, place your legs so that the toe of one touches the heel of the second limb.

Cerebellar function test

The gait is then assessed. The patient is asked to walk with a normal, straight, heel-to-toe gait and a flanking gait.

After this, dynamic ataxia is diagnosed. The patient is asked to stretch his arms in front of him and reach the tip of the nose or hammer with his index finger. The test is carried out with eyes open and closed.

The symmetry and synchrony of movements can be assessed using an asynergy test - the patient is asked to stretch his arms in front of him and make movements similar to screwing in light bulbs. Another diagnostic test is for dysmetria. The patient needs to raise both arms to shoulder level and extend them in front of him. After this, you need to raise one hand vertically up and lower it to the level of the second. The test is repeated on the opposite side.

Heel-knee test - in a lying position, the patient should touch the heel of one leg to the opposite knee.

Babinski's asinegria - the patient is asked to sit with his arms crossed over his chest. If the cause of impaired coordination of movements is in the cerebellum, it is not the body that rises, but the legs.

Treatment

In patients after a stroke, in the first hours after the disease, the restoration of blood circulation in the area of necrosis comes to the fore. Then nootropic and vascular drugs are prescribed. Their main task is to reduce the size of the lesion and help surviving neurons integrate into the general activity of the central nervous system.

As soon as possible, the patient begins motor exercises.

To improve coordination, it is necessary to perform complex targeted actions - lift small objects from the floor, open locks, “catch up” with moving objects with your hands, press buttons located at some distance from the patient. If it is necessary to coordinate the movements of two joints, then one of them is fixed and movements are carried out without it.

For vestibular ataxia, exercises are performed with increasing and decreasing the area of support, eliminating visual control - in the dark, blindfolded, with headphones. It is recommended to walk on uneven terrain, backwards, in a pattern. It is very useful to combine such exercises with eye exercises.

Massage, passive gymnastics, and physiotherapeutic procedures play an important role.

Ataxia (from the Greek ataxia - disorder) - a disorder of coordination and coordination of movements; a very common motor disorder. Strength in the limbs is slightly reduced or completely preserved. Movements become inaccurate, awkward, their continuity and consistency are disrupted, balance in a standing position and when walking is disturbed. Static ataxia is a violation of balance in a standing position, dynamic ataxia is a violation of coordination when moving.

Reasons for the development of the disease

There are many reasons that can trigger the development and manifestation of ataxia:

congenital malformations of the skull or brain,

damage to the cerebral arteries and insufficiency of cerebral blood supply,

traumatic injuries of the brain and spinal cord,

diseases of the vestibular apparatus,

demyelinating diseases,

benign and malignant brain tumors,

hydrocephalus,

hormonal diseases,

consequences of infectious diseases, neuroinfections,

poisoning with drugs and chemicals, alcoholism,

lack of vitamin B12.

Types and symptoms of ataxia

Depending on the causes of the disease and the characteristics of its manifestation, several types of ataxia are distinguished.

Sensitive ataxia occurs due to damage to the posterior columns and roots of the spinal cord, parietal cortex, peripheral nerves, and thalamus. With this form of the disease, patients bend their legs at the knee and hip joints and walk excessively (“stamping” gait). They feel like they are stepping on something soft. Lose the sense of space, not feeling the direction of movements. To reduce unsteadiness, they look at their feet, but if their eyes are closed, there is a complete loss of balance and coordination of movements.

Cerebellar ataxia occurs when there is damage to the vermis, peduncles and hemispheres of the cerebellum. During the Romberg test and when walking, the patient falls more towards the lesion. On the part of the affected hemisphere, uncoordinated, chaotic and delayed movements are made. Movements under visual control remain unchanged. Speech becomes slurred, slow, and reactions are inhibited. The handwriting of such people may change for the worse.

Vestibular ataxia develops as a result of damage to the balance organ - the brainstem nuclei, labyrinth and vestibular nerve. The main symptom is dizziness and, as a result, nausea and even vomiting. Horizontal nystagmus is also common. Increased dizziness occurs when the patient turns his head. At the same time, people stagger from one side to the other and can even fall, so they turn their heads very carefully, trying to have support.

Cortical ataxia is caused by disruption of the cerebellopontine pathway and damage to the frontal lobe. Patients have instability when walking, especially when turning. With severe lesions, astasia (impaired ability to stand) and abasia (impaired ability to walk) are observed. Mental disorders may also develop (memory problems, auditory and olfactory hallucinations), the functions of smell and hearing are impaired, and the grasping reflex gradually disappears.

There are also several hereditary forms of ataxia:

Pierre-Marie ataxia is characterized by atrophic destruction of the pons and inferior olives. Usually the disease manifests itself after 30 years of age in the form of unsteadiness of gait. Further, muscle tone increases with a decrease in muscle strength, and muscular dystrophy develops. Visual impairment and eyelid ptosis are also possible. Sometimes depression develops.

Louis-Bar syndrome (ataxia-telangiectasia) manifests itself in childhood and is characterized by pathology of the development of the thymus gland and immune deficiency. Often accompanied by extrapyramidal symptoms, mental retardation, and frequent acute respiratory viral infections.

Friedreich's familial ataxia is characterized by increasing degeneration of the spinal cord columns, damage to the cells of Clark's columns, Gaulle's fascicles and damage to the posterior spinocerebellar tracts. The first manifestations will be an uncertain swaying gait with legs spread wide apart. Subsequently, discoordination spreads to the arms, muscles of the face and chest, and tendon and periosteal reflexes decrease. Speech and facial expressions change, hearing decreases, heart pain, tachycardia, shortness of breath appear, and the tendency to dislocate joints increases.

Almost all forms of ataxia entail increased susceptibility to acute respiratory viral diseases, respiratory and heart failure.

A neurologist diagnoses and treats ataxia. During the examination, a number of neurological tests and functional tests are performed on the patient (Romberg test, tandem walking, etc.), computed or magnetic resonance imaging of the brain and spinal cord, electroneuromyography, EEG, ultrasound and Dopplerography of cerebral vessels, and biochemical studies are prescribed. blood, DNA diagnostics.

Treatment can be carried out comprehensively, taking into account the causes and mechanisms that caused ataxia. The medicinal part of therapy includes restorative, nootropic and vitamin therapy (B vitamins). According to indications, hormonal (demyelinating diseases), antiviral and antibacterial drugs (infectious diseases) are prescribed. In some cases, surgical intervention is indicated: to remove a tumor or hematoma in the brain, to expand the cranial fossa in case of Arnold-Chiari anomaly, to ensure the outflow of cerebrospinal fluid in case of hydrocephalus.

Physiotherapy is an important component in the treatment of patients with ataxia. It is aimed at preventing various complications (such as contractures and muscle atrophy), maintaining physical fitness, improving coordination and walking. Special complexes of “cerebellar” and “sensory” exercises are recommended, as well as procedures with biofeedback and stabilography.

The most effective treatment is in, as it allows you to combine drug treatment methods and rehabilitation measures. The special equipment that the centers are equipped with and the experience of the staff provide the best results in the treatment of neurological diseases.

If you have any gait disturbances, a feeling of loss of balance, muscle and tendon weakness of the limbs, contact a neurologist at the Aximed clinic. High-quality diagnostics using modern equipment and timely treatment selected by an experienced neurologist will help to understand the causes of the disease, select effective therapy, improve the quality of life and level out neurological deficits.

Motor coordination is the ability to make precise, purposeful movements.

Impaired coordination of movements means that some kind of communication disruption has occurred in the central nervous system. A branched system of nerves is located in the space of the brain and spinal cord. The signal that you send to your muscles to perform a movement of an arm, leg, or other part of the body must pass through it. When the central nervous system is disrupted, distortion or incorrect signal transmission occurs.

Muscle control problems can be caused by many factors. These include severe exhaustion, alcohol and drug abuse, head injuries, multiple sclerosis, muscular dystrophies, Parkinson's disease, stroke and catalepsy (a rare form of muscle weakness that occurs in some people under the influence of strong emotions, such as anger or joy).
Poor coordination of movements is dangerous for the patient, as it can lead to a fall and injury.

Impaired coordination of movements can be observed in elderly patients, as well as in people with neurological diseases, for example, after a stroke. Often, poor coordination can be associated with changes in the musculoskeletal system (impaired coordinated muscle function, weakness in the muscles of the thigh and lower leg, etc.). Observing such people, you can notice that he has disorders of standing and walking, all movements become uncoordinated, loose, and sweeping. A person cannot draw a circle in the air with his hand (the result is a broken, zigzag line). Cannot accurately hit the tip of the nose with the index finger. Lack of stability when moving affects a person's handwriting: the lines become crooked and run over each other, the letters become uneven and large.

Examples of poor motor coordination include:

Shaking of the limbs or head (tremor)

The tremor can be quite significant or almost unnoticeable. Sometimes it appears during movement, in other cases - on the contrary, at the moment of rest. Tremors can increase with anxiety and stress. Insufficiently strong trunk muscles do not create a strong, stable foundation for the movement of arms and legs. As a result, when walking, the legs step unevenly, the steps become uneven, and unsteadiness occurs.

Ataxia

Impaired coordination of movements due to damage to the frontal lobes of the brain, cerebellum, and deep sensory pathways in the spinal cord and brain. It manifests itself as an imbalance when standing (static ataxia) or a disorder of motor coordination (dynamic ataxia).

What diseases cause coordination problems?

Dystrophy
Parkinson's disease
Stroke
Catalepsy
Poisoning
Aging

Which doctors should I contact if coordination problems occur?

Neurologist
Cardiologist
Toxicologist