What are the causes of caffeine-induced ataxia (cerebellar dysfunction)?

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Last updated: April 24, 2025View editorial policy

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From the Guidelines

Caffeine-induced ataxia is caused by excessive caffeine consumption, typically exceeding 400-500mg, which disrupts normal brain function, particularly in the cerebellum, leading to coordination and balance problems. This occurs when high levels of caffeine overstimulate the central nervous system by blocking adenosine receptors, leading to irregular neural firing patterns, as supported by the biological effects of caffeine on the stimulation of the central and sympathetic nervous system 1. Caffeine also increases calcium release in muscle cells and affects GABA neurotransmitter function, further contributing to coordination problems.

Symptoms of caffeine-induced ataxia typically appear after consuming large amounts of caffeine and may include:

  • Unsteady gait
  • Poor coordination
  • Tremors
  • Difficulty with fine motor skills The condition is generally temporary and resolves as caffeine is metabolized and eliminated from the body, typically within 24-48 hours.

Individuals with certain neurological conditions, the elderly, and those taking medications that interact with caffeine may be more susceptible to developing ataxia at lower doses, as suggested by the potential adverse effects of caffeine in different demographic groups 1. Treatment involves stopping caffeine intake, staying hydrated, and resting until symptoms subside. In severe cases, medical attention may be necessary, especially if symptoms persist beyond the expected caffeine clearance time. It is essential to note that the European Food Safety Authority advises pregnant women to limit caffeine intake to 200 mg/d, and healthy individuals should not exceed 400 mg/d, to minimize the risk of adverse effects, including ataxia 1.

From the Research

Caffeine Induced Ataxia Causes

  • Caffeine can have both positive and negative effects on ataxia, depending on the context and individual circumstances 2, 3.
  • Ataxia is a disorder of balance and coordination resulting from dysfunctions involving the cerebellum and its afferent and efferent connections 4, 5.
  • Caffeine has been shown to alleviate progressive motor deficits in a transgenic mouse model of spinocerebellar ataxia, suggesting potential therapeutic benefits 2.
  • However, caffeine consumption has also been found to reduce performance in bipedal standing balance assessments in older adults, potentially increasing the risk of falls 3.
  • The neuroprotective effects of caffeine against complex I inhibition-induced apoptosis are mediated by inhibition of the Atm/p53/E2F-1 path in cerebellar granule neurons, which may be relevant to the development of ataxia 6.

Key Findings

  • Caffeine can attenuate the progressive loss of motor function and balance in animal models of ataxia 2.
  • Caffeine consumption can have negative effects on balance performance in older adults, particularly in bipedal standing assessments 3.
  • The introduction of a cognitive dual task can reduce performance in both balance and cognitive tests, with limited modulation by caffeine consumption 3.

Relevant Studies

  • A 2017 study published in the Annals of Neurology found that caffeine alleviates progressive motor deficits in a transgenic mouse model of spinocerebellar ataxia 2.
  • A 2020 study published in Nutrients found that caffeine consumption reduces performance in bipedal standing balance assessments in older adults 3.
  • A 2007 study published in the Journal of Neuroscience Research found that the neuroprotective effects of caffeine against complex I inhibition-induced apoptosis are mediated by inhibition of the Atm/p53/E2F-1 path in cerebellar granule neurons 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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