Ataxia after brain injury

Each day, we rely on numerous bodily movements to get up, get dressed, make our breakfasts, go out, interact with others, do the shopping, and any number of other such daily activities.

Many people know that it is our muscles that are responsible for our body moving, but the brain also plays a vital part in this by coordinating the movement of muscles. When the brain gets injured, the ability to coordinate muscles may be  affected, which can affect different types of movement. This is called ataxia.

What skills does ataxia affect?

Ataxia affects movement, balance and co-ordination, which all rely on muscular control. Ataxia can therefore cause issues with:

• Walking
• Vision
• Speech
• Swallowing
• Continence (bladder and bowel functions)
• Using one’s hands for activities such as eating, dressing or writing

Vision relies on movement of muscles around the eyes. Even when we think our eyes are still, they are constantly moving back and forth to process the world around us. A brain injury can affect the control of these muscular movements, which can cause a range of visual problems that contribute to
ataxia.

Similarly, speech, swallowing and continence are all functions that rely on muscular control. If parts of the brain responsible for controlling these muscles get injured, these functions can be disrupted. For example, some people experience dysarthria, which is a difficulty with speech, and/or dysphagia, a  difficulty with swallowing.

Ataxia can cause muscles to spasm, which can be uncomfortable or painful
to live with.

Where can someone get support for living with ataxia?

Ataxia can cause a wide range of issues. The professional best suited to support a brain injury survivor with ataxia will therefore depend on the specific issues the survivor experiences. Some of the professionals that may be able to help are as follows:

• Physiotherapists - to help with movement issues
• Speech and language therapists - to help with speech and swallowing issues
• Occupational therapists - to help with accessing and using adaptive equipment, and learning adaptive ways of completing activities
• Nurses - to administer and monitor medication
• Continence specialists - to help with continence (bladder and bowel function) issues
• Neuropsychologists or clinical psychologists - to help with the emotional, cognitive or behavioural impact of brain injury

If the survivor’s ataxia is causing difficulties with day-to-day living, their GP or neurologist may be able to refer them to an Ataxia centre, clinic or a professional specialist in ataxia.

More information on accessing professional support is available on Ataxia UK’s website at www.ataxia.org.uk.

How can someone cope with ataxia?

Get support - for instance, professional support, support from agencies to help with aspects of your life that you are struggling with, and/or support from charities such as Headway and Ataxia UK.

Keep walkways clear to avoid tripping. Consider installing grab rails for safety.

Speak to your GP about symptoms of ataxia that you are struggling with. They may be able to prescribe helpful medication or provide referrals to relevant services. For instance, there may be specialist clinics nearby that your GP can refer you to, such as spasticity clinics, continence clinics or pain clinics.

Consider deep breathing exercises to help with calming the body.

Explore adaptive equipment that can help you with managing day-to-day life, such as mobility aids, adaptive kitchen equipment or walking aids.

Discuss helpful exercises with a physiotherapist to help with balance and gait issues.

Explore adapted activities, such as accessible holidays or adapted sports.

Be honest with others in your life about how you are feeling, as they may not understand how your brain injury has affected you, especially if your symptoms are not visible to others. Talk to others about your experiences, your feelings, and how they can best support you.

Avoid drinking alcohol if possible, as this may worsen ataxia issues such as balance, speech and gait. Alcohol is generally discouraged after brain injury as a brain injury can reduce one’s tolerance to it.

For more information on ataxia after brain injury, download our new publication Ataxia after brain injury below.