From the Guidelines
Rheumatological conditions associated with ataxia include inflammatory and demyelinating diseases, such as multiple sclerosis, neuromyelitis optica, and acute disseminated encephalomyelitis, as well as other inflammatory causes like neurosarcoidosis. These conditions can affect the spinal cord, leading to symptoms of ataxia due to disturbances in proprioception and motor function 1. Some key points to consider include:
- Inflammatory and demyelinating diseases can cause ataxia by affecting the spinal cord or cerebellum
- Other inflammatory causes, such as neurosarcoidosis, can also lead to ataxia
- Treatment typically involves immunosuppressive medications, and early diagnosis and treatment are essential to prevent irreversible neurological damage
- The primary goal of treating patients with these conditions is to maximize long-term health-related quality of life through control of symptoms and inflammation, prevention of progressive structural damage, preservation/normalization of function, and social participation 1 Some of the rheumatological conditions associated with ataxia may include:
- Multiple sclerosis
- Neuromyelitis optica
- Acute disseminated encephalomyelitis
- Neurosarcoidosis It is essential to note that these conditions can have diverse manifestations and may require multidisciplinary treatment coordinated by a rheumatologist 1. The optimal management of patients with these conditions requires a combination of non-pharmacological and pharmacological treatment modalities, and treatment should aim at optimal care based on a shared decision between the patient and the rheumatologist. In terms of treatment, immunosuppressive medications like corticosteroids, methotrexate, or rituximab may be used, depending on the specific condition and severity 1. Early diagnosis and treatment are crucial to prevent irreversible neurological damage, and a multidisciplinary approach to care is often necessary to address the diverse manifestations of these conditions 1.
From the Research
Rheumatological Conditions Associated with Ataxia
There are no direct research papers provided to assist in answering this question. However, we can discuss some rheumatological conditions that may be associated with ataxia:
- Systemic lupus erythematosus (SLE) 2, 3, 4, 5: a chronic autoimmune disease that can affect multiple organ systems, including the nervous system, and may cause ataxia.
- Rheumatoid arthritis (RA) 2, 3, 4, 5, 6: a chronic autoimmune disease that primarily affects the joints, but can also affect other systems, including the nervous system, and may cause ataxia.
Pathophysiology
The pathophysiology of SLE and RA involves the innate immune system, with macrophages and fibroblast-like synoviocytes playing a key role in RA 3, and the complement system being a major effector of the inflammatory process in SLE 3.
- Neutrophils also play a role in the pathogenesis of both RA and SLE, with dysregulated neutrophil activation contributing to tissue damage and destruction 6.
- The role of the innate immune system in the pathophysiology of RA and SLE is not only important in early stages but is essential to maintain the immune response and to allow disease progression 3.
Clinical Significance
The clinical significance of SLE features in RA is uncertain, but studies have shown that patients with RA who develop SLE features have an increased risk of death 5.