Sensory Ataxia Due to Peripheral Neuropathy
Peripheral neuropathy refers to lack of sensation (or in a number of cases burning, tingling pain) beginning in the bottom of the feet (often in the toes), spreading gradually up the legs symmetrically.
Peripheral neuropathy affects the balance because we are very reliant on the information coming from the bottom of the feet to tell us where the ground is, and we are nearly continuously making micro-adjustments in our feet, toes, and ankles to maintain our center of gravity. If the sensory information coming from the feet is absent or delayed, these adjustments either do not occur or are delayed, causing patients to lose their balance or stagger.
Most cases of peripheral neuropathy can be diagnosed clinically but occasionally nerve conduction studies are required. This entails applying an electrical current to the nerve, stimulating the nerve, and measuring the response down the nerve. There is no damage to the nerve with electrical stimulation and typically only a mild, temporary discomfort associated. Certain blood tests are usually required to assess for the cause of neuropathy. The most common causes of neuropathy are diabetes, vitamin B12 deficiency, alcohol-related, and age-related.
Treatment of sensory ataxia depends on the cause of the neuropathy. For example, vitamin B12 deficiency is treated with vitamin B12 supplementation (typically starting with injections then switching to oral); diabetic neuropathy is managed by maintaining tight sugar control. Regardless of the cause of neuropathy, balance and gait are often improved by physical therapy.