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Published in: The Cerebellum 2/2014

01-04-2014 | Review

Consensus Paper: Management of Degenerative Cerebellar Disorders

Authors: W. Ilg, A. J. Bastian, S. Boesch, R. G. Burciu, P. Celnik, J. Claaßen, K. Feil, R. Kalla, I. Miyai, W. Nachbauer, L. Schöls, M. Strupp, M. Synofzik, J. Teufel, D. Timmann

Published in: The Cerebellum | Issue 2/2014

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Abstract

Treatment of motor symptoms of degenerative cerebellar ataxia remains difficult. Yet there are recent developments that are likely to lead to significant improvements in the future. Most desirable would be a causative treatment of the underlying cerebellar disease. This is currently available only for a very small subset of cerebellar ataxias with known metabolic dysfunction. However, increasing knowledge of the pathophysiology of hereditary ataxia should lead to an increasing number of medically sensible drug trials. In this paper, data from recent drug trials in patients with recessive and dominant cerebellar ataxias will be summarized. There is consensus that up to date, no medication has been proven effective. Aminopyridines and acetazolamide are the only exception, which are beneficial in patients with episodic ataxia type 2. Aminopyridines are also effective in a subset of patients presenting with downbeat nystagmus. As such, all authors agreed that the mainstays of treatment of degenerative cerebellar ataxia are currently physiotherapy, occupational therapy, and speech therapy. For many years, well-controlled rehabilitation studies in patients with cerebellar ataxia were lacking. Data of recently published studies show that coordinative training improves motor function in both adult and juvenile patients with cerebellar degeneration. Given the well-known contribution of the cerebellum to motor learning, possible mechanisms underlying improvement will be outlined. There is consensus that evidence-based guidelines for the physiotherapy of degenerative cerebellar ataxia need to be developed. Future developments in physiotherapeutical interventions will be discussed including application of non-invasive brain stimulation.
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Metadata
Title
Consensus Paper: Management of Degenerative Cerebellar Disorders
Authors
W. Ilg
A. J. Bastian
S. Boesch
R. G. Burciu
P. Celnik
J. Claaßen
K. Feil
R. Kalla
I. Miyai
W. Nachbauer
L. Schöls
M. Strupp
M. Synofzik
J. Teufel
D. Timmann
Publication date
01-04-2014
Publisher
Springer US
Published in
The Cerebellum / Issue 2/2014
Print ISSN: 1473-4222
Electronic ISSN: 1473-4230
DOI
https://doi.org/10.1007/s12311-013-0531-6

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