CLINICAL PRESENTATION

Symptoms and signs may include gait impairment, visual blurring due to nystagmus, unclear (“scanning”) speech, hand incoordination, and tremor with movement. Differential diagnosis: Unsteady gait associated with vertigo from vestibular nerve or labyrinthine disease can resemble gait instability of cerebellar disease but produces a perception of movement, dizziness, or light-headedness. Sensory disturbances also can simulate cerebellar disease; with sensory ataxia, imbalance dramatically worsens when visual input is removed (Romberg sign). Bilateral proximal leg weakness also can rarely mimic cerebellar ataxia.