Ataxia

Definition

Ataxia is a clinical sign of impaired coordination and balance resulting from dysfunction of the cerebellum, its connections, or sensory pathways. Patients exhibit wide-based unsteady gait, poor fine motor control, and dysmetria (overshooting or undershooting targets).

Common Causes

• Multiple sclerosis and cerebellar stroke
• Alcohol intoxication and chronic alcoholism
• Brain tumor (especially posterior fossa)
• Hereditary ataxias (Friedreich ataxia)
• Vitamin deficiencies (B12, thiamine)
• Medications (phenytoin, lithium toxicity)

Assessment Techniques

Romberg test (stand with eyes closed), finger-to-nose, heel-to-shin, rapid alternating movements, tandem (heel-to-toe) gait.

Nursing Interventions

Implement fall precautions: keep bed low, use gait belt, provide assistive devices (cane, walker), ensure well-lit clear pathways. Refer to physical and occupational therapy. Review medications for contributing agents.

NCLEX Relevance

Recognize ataxia as a safety risk requiring fall precautions, such as common in MS, cerebellar stroke, and medication toxicity scenarios.