What to do about untreatable cerebellar ataxia

  Cerebellar ataxia can have many causes, including encephalitis, cerebellar infarction, cerebellar hemorrhage, hereditary cerebellar degeneration, and multisystem atrophy. With acute cerebellar damage, patients mainly show balance disorders, difficulty walking, a 2-3 meter walk is a 10,000-mile journey for them, and poor self-care ability in life. Lads with acute cerebellar inflammation can’t even get up by themselves, they have a lot of strength and won’t use it, because the cerebellum is mainly the coordinating center for movement. Acute cerebellar hemorrhage, if the amount of bleeding is large, the acute phase is life-threatening, and after the acute phase, there will be uncoordinated movement of the arms and legs, ambiguous speech, and after eating, when you turn over, all that you have eaten is vomited out. Patients with this kind of acute cerebellar injury often need about 3 months to slowly recover, relying on the brain and the healthy side of the cerebellum to compensate for the restoration of balance function.  However, some patients with chronic cerebellar degeneration tend to only get heavier and heavier, with no medicine to cure them. What can be done? These patients are often in their 40s and 65s, and are in their prime, which seriously affects their life and work.  The combination of transcranial direct current stimulation (tDCS) and Frankel balance training has recently been found to be a promising treatment for patients with intractable cerebellar atrophy degeneration. These patients with cerebellar ataxia, who often undergo atrophy and degeneration of the cerebellum, need balance training to use the whole brain to compensate for the function of the cerebellum and also to improve the function of the cerebellum through training. tDCS DC stimulation, which increases the excitability of the cerebellum, also increases the network connections between the cerebellum and the brain. After stimulation, balance training can be more likely to produce neuroplasticity under conditions of neuronal excitation, which can have a therapeutic effect on balance abnormalities.  We recently treated a patient with cerebellar ataxia due to multiple system atrophy, and after 5 days of transcranial direct current stimulation tDCS combined with Frankel balance training the patient reported improvement when walking.