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Management of Dizziness in Ataxia

Management of Dizziness in Ataxia. Joanna C. Jen, M.D., Ph.D. UCLA Neurology jjen@ucla.edu. Dizziness. Light-headed near-faint dizziness Floating, swimming, rocking sensation Medication-related dizziness Vertigo Disequilibrium Onset? Intermittent vs. continuous? Triggers?.

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Management of Dizziness in Ataxia

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  1. Management of Dizziness in Ataxia Joanna C. Jen, M.D., Ph.D. UCLA Neurology jjen@ucla.edu

  2. Dizziness • Light-headed near-faint dizziness • Floating, swimming, rocking sensation • Medication-related dizziness • Vertigo • Disequilibrium Onset? Intermittent vs. continuous? Triggers?

  3. Causes of Dizziness in Ataxia • Cerebellar • Peripheral vestibular • Sensory • Autonomic -Abnormal eye movement -Gait instability with risk for falls • Vascular • Neoplastic • Infectious • Metabolic/nutritional • Degenerative • Congenital/hereditary

  4. Management of Dizziness in Ataxia • Correct diagnosis • Correct drug with appropriate dosage and duration and minimize side effects • Gait training- PT • Fall prevention- PT/OT

  5. Associated Sxs & Rxs Memantine Gabapentin Baclofen 4-aminopyridine • Oscillopsia- involuntary jerky eye movement (nystagmus: vertical, gaze-evoked) making everything jump up and down or from side to side • Nausea/vomiting • Vague feeling of unsteadiness Short-term antiemetics; Avoid long-term benzodiazepines Tricyclic antidepressants SSRIs

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