Ataxia

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Ataxia (do grego ατάξις, sem coordenação) ou distaxia é um transtorno neurológico caracterizado pela falta de coordenação de movimentos musculares voluntários e o equilíbrio de um animal. É normalmente associada a uma degeneração ou bloqueio de áreas específicas do cérebro e cerebelo.

Classificação[editar | editar código-fonte]

  • Ataxia cerebelar: Causada por danos à vias cerebelares, resultam da perda de coordenação motora e planejamento dos movimentos. Os sintomas dependem da área do cerebelo afetada.
  • Ataxia vestibular: Causada por danos à via vestíbulo-ponto-cerebelar, resultam da perda de equilíbrio gerando vertigem e náusea.
  • Ataxia sensorial: Causada por danos às vias aferentes e posteriores, resultam da perda de propriocepção (percepção de si mesmo no espaço).

Causas[editar | editar código-fonte]

Existem inúmeras causas para ataxias, podendo ocorrer de forma isolada ou simultânea, de forma aguda ou crônica. [1]

Sinais e sintomas[editar | editar código-fonte]

O cerebelo é responsável por uma série de comandos centrais tendo papel de destaque na elaboração, aprendizagem e execução da motricidade. Os possíveis sintomas incluem:

  • Disdiadococinesia: Dificuldade de realizar movimentos alternados.
  • Tremor: Manifesta-se durante um movimento voluntário
  • Dismetria: Erro na medida de movimentos
  • Distasia: Dificuldade de manter-se em pé
  • Disbasia: Dificuldade na marcha, marcha ebriosa
  • Disartria: Dificuldade na fala, fala pastosa
  • Nistagmo: Incoordenação do músculo do globo ocular.

Tratamento[editar | editar código-fonte]

Depende da causa, mas frequentemente é apenas para reduzir os sintomas sem cura permanente. Terapia ocupacional e fisioterapia podem melhorar o funcionamento cotidiano e social. [3] Diversos medicamentos podem reduzir os tremores em ataxias neurodegenerativas entre eles: idebenona, amantadina, fisostigmina, L-carnitina ou seus derivados, trimetoprim-sulfametoxazol, vigabatrina, fosfatidilcolina, acetazolamida, 4-aminopiridina, buspirona, e uma combinação de coenzima Q10 e vitamina E.[4]

Referências[editar | editar código-fonte]

  1.  Victor M, Ropper AH, Adams RD, Samuels M (2009). Adams and Victor's Principles of Neurology (Ninth ed.). McGraw-Hill Medical. pp. 78–88. <a href="https://en.wikipedia.org/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="https://en.wikipedia.org/wiki/Special:BookSources/0-07-149992-X" title="Special:BookSources/0-07-149992-X">0-07-149992-X</a>.
  2. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5834a2.htm?s_cid=mm5834a2
  3.  Victor M, Ropper AH, Adams RD, Samuels M (2009). Adams and Victor's Principles of Neurology (Ninth ed.). McGraw-Hill Medical. pp. 78–88. <a href="https://en.wikipedia.org/wiki/International_Standard_Book_Number" title="International Standard Book Number">ISBN</a> <a href="https://en.wikipedia.org/wiki/Special:BookSources/0-07-149992-X" title="Special:BookSources/0-07-149992-X">0-07-149992-X</a>.
  4. Trujillo-Martín MM, Serrano-Aguilar P, Monton-Alvarez F, Carrillo-Fumero R (June 2009). "Effectiveness and safety of treatments for degenerative ataxias: a systematic review". Mov. Disord. 24 (8): 1111–24. <a href="https://en.wikipedia.org/wiki/Digital_object_identifier" title="Digital object identifier" style="background-color: rgb(221, 238, 255); font-size: 11.818181991577148px; line-height: 17.280000686645508px;">doi</a>:<a href="http://dx.doi.org/10.1002%2Fmds.22564" rel="nofollow" class="external text" style="color: rgb(102, 51, 102); background-image: linear-gradient(transparent, transparent), 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); background-color: rgb(221, 238, 255); padding-right: 13px; font-size: 11.818181991577148px; line-height: 17.280000686645508px; background-position: 100% 50%, 100% 50%; background-repeat: no-repeat no-repeat;">10.1002/mds.22564</a><a href="https://en.wikipedia.org/wiki/PubMed_Identifier" title="PubMed Identifier" class="mw-redirect" style="background-color: rgb(221, 238, 255); font-size: 11.818181991577148px; line-height: 17.280000686645508px;">PMID</a> <a href="https://www.ncbi.nlm.nih.gov/pubmed/19412936" rel="nofollow" class="external text" style="color: rgb(102, 51, 102); background-image: linear-gradient(transparent, transparent), 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background-color: rgb(221, 238, 255); padding-right: 13px; font-size: 11.818181991577148px; line-height: 17.280000686645508px; background-position: 100% 50%, 100% 50%; background-repeat: no-repeat no-repeat;">19412936</a>.

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