Ataxia in superficial siderosis describes the incoordination resulting from loss of voluntary muscle control, often beginning with your arms or legs. This form of ataxia is considered a symptom of your superficial siderosis condition and differs from Hereditary or Sporadic which are distinct neurological diseases. Superficial siderosis patients frequently experience different cerebellar ataxia symptoms combined with signs of central and peripheral vestibulopathy.
Ataxia or Vestibular?
There seem to be two underlying causes in Garys' case. First, sometimes he describes a dizzy spinning sensation when he stands, closer to vertigo. Second, 15 years ago, he landed in the hospital after an exceptionally severe bout of rotational vertigo. This event was prediagnosis, so his ENT put him through a series of vestibular testing. Unable to determine the cause, the event was recorded as a vestibular event, cause unknown. These episodes of vertigo eventually tapered off to not happening ten years ago. That is until recently when it's begun again.
Gary's cerebellum and brainstem are heavily coated with hemosiderin and showing some atrophy. His symptoms tick off most of the Ataxia boxes. His balance and gait are perfect examples of classic superficial siderosis progression. In the early years, he only experienced balance problems on uneven surfaces or in shadowed areas. Now it's unsafe for him to walk without the aid of a walker. Recently he tried to cross the bedroom in the dark and fell, twisting his smaller aluminum walker into a mess.
There Is Always A Test
In 2018 Gary went to the kinesiology unit for a balance and gait evaluation. It helps to have a baseline test score for two reasons. The first is simple, how great is your fall risk? Second, your physical therapist is qualified to determine which assistive devices would best suit your case if they know your risk score.
Also, for superficial siderosis patients who have chosen to try chelation therapy, if your score remains constant with no progressive decline or if you see an improvement, then it's a good indication your is working.
POMA: Performance-Oriented Mobility Assessment
The performance-oriented mobility assessment (POMA).4 is commonly referred to as The Tinetti Test , in honor of its creator, Mary Tinetti. The evaluation was designed to indicate a fall risk accurately and maneuverability level to produce a better predictive result on re-testing.
Cerebellar degeneration or atrophy is often the underlying cause of cerebellar Ataxia. The cerebellum plays a significant role in coordinating your fine motor function, gait, balance, vision, and swallowing. Cerebellar Ataxia will also cause fatigue, affect your executive function, personality, mood, and increase your risk of depression.