Truncal Ataxia

Truncal ataxia (or trunk ataxia) is a wide-based "drunken sailor" gait characterised by uncertain starts and stops, lateral deviations and unequal steps. It is an instability of the trunk and often seen during sitting. It is most visible when shifting position or walking heel-to-toe.

As a result of this gait impairment, falling is a concern in patients with ataxia.

Truncal ataxia affects the muscles closer to the body such as the trunk, shoulder girdle and hip girdle. It is involved in gait stability.

Truncal ataxia is different from appendicular ataxia. Appendicular ataxia affects the movements of the arms and legs. It is caused by lesions of the cerebellar hemispheres.

Causes

Truncal ataxia is caused by midline damage to the cerebellar vermis. There are at least 34 conditions that cause truncal ataxia.

Common

  • Alcohol intoxication
  • Cerebral infarction
  • Cerebral hemorrhage
  • Cerebellar ataxia
  • Multiple sclerosis
  • Friedreich's ataxia
  • Drugs such as Benzodiazepines, Lithium, Phenytoin

Uncommon

  • Adrenoleukodystrophy
  • Ataxia oculomotor apraxia type 1
  • Branchial myoclonus
  • Christianson syndrome
  • Dandy–Walker syndrome
  • Dysequilibrium syndrome
  • Epilepsy
  • Episodic ataxia
  • Post viral cerebellar ataxia
  • Gerstmann–Sträussler–Scheinker syndrome
  • Machado–Joseph disease
  • Microcephaly
  • N-acetylaspartate deficiency
  • Neuhauser–Eichner–Opitz syndrome
  • Paraneoplastic cerebellar degeneration
  • Polymicrogyria
  • Rett syndrome
  • Spinocerebellar ataxia
  • Vertebral dissection