sensoryataxia

Sensory ataxia, sometimes written as sensoryataxia, is a form of ataxia caused by impaired somatosensory input from the limbs and trunk. It results from dysfunction of the dorsal columns of the spinal cord or from peripheral sensory nerves, leading to reduced perception of vibration, position, and touch that normally guide movement. Unlike cerebellar ataxia, sensory ataxia tends to worsen when visual input is removed.

Patients typically present with a wide-based, unsteady gait and difficulty walking in the dark or on uneven surfaces. Romberg sign is often positive, and there is impaired proprioception and vibration sense in the legs. Paresthesias or numbness may accompany the sensory loss. Eye closure often worsens imbalance because the patient cannot rely on intact somatosensory cues.

Common causes include diabetic polyneuropathy, B12 or copper deficiency, chronic inflammatory demyelinating polyneuropathy, tabes dorsalis and other dorsal column diseases, cervical spondylotic myelopathy, spinal cord infarction, and certain hereditary sensory neuropathies. Alcohol-related and certain autoimmune or infectious processes can contribute. The underlying condition typically guides prognosis and treatment.

Diagnosis is based on clinical presentation and neurologic examination, supported by nerve conduction studies showing peripheral sensory involvement or MRI evidence of dorsal column pathology. Laboratory tests assess vitamins and minerals (eg, B12, copper), metabolic disorders, and inflammatory or infectious etiologies. Management focuses on treating the underlying cause, supplemented by physical therapy, balance training, assistive devices if needed, and safety measures to prevent falls.

Prognosis varies with etiology and response to treatment; some cases stabilize with correction of the underlying issue, while others progress despite therapy.