Ataxia is derived from the Greek word taxis meaning ‘order’. Hence, ataxia can be translated as lack of order. A patient with ataxia may have either cerebellar ataxia or so-called sensory ataxia. In most patients, a relatively common cause such as excessive alcohol consumption, drug or toxin exposure, stroke or multiple sclerosis is easily identified. But when these causes have been excluded, it can be difficult to know what to do next. In particular, there is often confusion surrounding the myriad of available tests, both genetic and non-genetic. In addition, there is a risk that patients with undiagnosed ataxia will be ‘forgotten’ after the initial set of tests prove unhelpful, although many of them have a slowly progressive disorder. But, even though the diagnostic yield of further investigation is not high, it is wise regularly to revisit the diagnosis (or lack of one!) and to consider whether there are
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