From the Guidelines
Trunk ataxia is typically caused by damage to the cerebellum or its connections, which control coordination and motor planning, and can also result from disruptions in several neuronal circuits impacting the basal ganglia, cerebral cortex, spinal cord, and peripheral nerves, as well as the sensory and vestibular system. The causes of trunk ataxia can be varied and include cerebellar vermian pathology, which is a common cause of truncal ataxia 1. Other potential causes of trunk ataxia include:
- Cerebellar atrophy or infarction
- Vestibular dysfunction
- Sensory ataxia
- Muscle weakness and hypotonia
- Epilepsy, which can present with postictal ataxia
- Functional disorders, which can cause "pseudoataxia" 1
- Inherited or genetic syndromes, such as ataxia-telangiectasia, Friedreich ataxia, and spinocerebellar ataxias 1
- Acquired conditions, such as paraneoplastic cerebellar degeneration, acute cerebellitis, and superficial siderosis 1
- Toxic or metabolic disorders, such as those caused by substance abuse, mercury poisoning, or vitamin E deficiency 1
- Congenital malformations of the midbrain and cerebellum, such as Chiari I, cerebellar hypoplasias or agenesis, and Joubert syndrome 1
The evaluation of trunk ataxia requires a careful review of demographics, history, clinical examination, laboratory testing, and neuroimaging to reach a cohesive diagnosis 1. The choice of imaging modality depends on the suspected underlying cause and may include MRI, CT, or CTA of the head and neck 1. The most appropriate initial imaging modality for trunk ataxia is MRI of the entire brain without and with IV contrast, which offers better visualization of the posterior fossa and can detect subtle changes in the cerebellum and brainstem 1.
From the FDA Drug Label
Clonazepam tablets may cause problems with your coordination, especially when you are walking or picking things up
The causes of trunk ataxia (loss of coordination in the trunk) are not explicitly stated in the provided drug labels. However, it can be inferred that clonazepam may contribute to coordination problems, which could potentially include trunk ataxia.
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From the Research
Causes of Trunk Ataxia
The causes of trunk ataxia, which is characterized by a loss of coordination in the trunk, can be attributed to various factors. Some of the possible causes include:
- Degenerative cerebellar ataxia, which is a progressive condition that affects the cerebellum and can lead to trunk ataxia 3
- Traumatic brain injury (TBI), which can cause damage to the cerebellum and result in trunk ataxia 4
- Autosomal recessive hereditary ataxia, a genetic disorder that can affect the cerebellum and lead to trunk ataxia 5
- Other conditions such as multiple sclerosis, Ramsey-Hunt syndrome, and pontine myelinolysis, which can also cause trunk ataxia 6
Factors Contributing to Trunk Ataxia
Several factors can contribute to the development and progression of trunk ataxia, including:
- Damage to the cerebellum, which is responsible for coordinating movement and balance 3
- Impairment of the serotonergic system, which plays a role in regulating movement and coordination 6
- Age and disease severity, which can affect the severity of trunk ataxia and the risk of falls 7
- History of falls, which can be a consequence of trunk ataxia and can further exacerbate the condition 7
Assessment and Treatment of Trunk Ataxia
Trunk ataxia can be assessed using various tools and techniques, including:
- The International Cooperative Ataxia Rating Scale (ICARS), which evaluates the severity of ataxia 3, 7
- Trunk stabilization and balance exercises, which can help improve trunk control and reduce the risk of falls 4, 5
- Functional trunk training, which can be an effective method for improving upper limb performance and dynamic trunk balance in patients with autosomal recessive hereditary ataxia 5
- Medications such as buspirone, which has been shown to improve cerebellar symptoms in patients with ataxia 6