Definition

Friedreich’s ataxia is a rare, inherited disease. It causes a gradual breakdown of the nervous system. Friedreich’s ataxia affects nerves in the brain and spinal cord that control movement. It also affects sensory nerves that help with coordination. In later stages, the disease can cause injury to the heart and pancreas.

Causes

Friedreich’s ataxia is caused by a problem with a gene called the frataxin gene. This gene is found on chromosome 9q13. To develop this disease, a person must inherit a copy of the defective gene from each parent. However, there are some people with Friedreich’s ataxia that have no family history of the disorder.

Risk Factors

There are no known risk factors other than having a parent with the frataxin gene.

Symptoms

Symptoms can be different for each person. The most common include:

• Leg weakness, including difficulty walking
• Loss of coordination
• Difficulty speaking and swallowing
• Foot deformities
• Foot ulcers
• Hearing loss and/or vision loss
• Eye movement abnormalities
• Movement disorders such as tremor, dystonia, and chorea

Diagnosis

Your doctor will ask about your symptoms. You will also be asked about your medical history, family history, and current medication. A physical exam will be done. If Friedrich’s ataxia is suspected, you may also see a doctor who specializes in the nervous system.

Images may need to be taken of your bodily structures. This can be done with:

• CT scan
• MRI scan
• Echocardiogram

The function of your muscles and nerves may be tested. This can be done with:

• Electromyogram (EMG)
• Nerve conduction studies

The electrical activity of your heart may be assessed. This can be done with:

• Electrocardiogram (EKG)
• 24-hour holter monitoring

Your bodily fluids and tissues may be tested. This can be done with:

• Genetic testing for the frataxin gene
• Blood and urine tests
• Nerve or muscle biopsy

Treatment

There is no known cure for this condition.

Long-term management is aimed at maintaining as much function as possible and controlling symptoms. Some treatments that may help include:

• Physical therapy and rehabilitation to cope with muscle weakness
• Putting orthotics in your shoes to provide stability and to help with weakness
• Surgery for correcting foot abnormalities and scoliosis
• Periodic testing for associated conditions of diabetes and cardiomyopathy

Prevention

There are no current guidelines to prevent Friedreich’s ataxia.

National Ataxia Foundation http://www.ataxia.org

Muscular Dystrophy Canada http://www.muscle.ca

Friedrich’s ataxia (FA). Muscular Dystrophy Association website. Available at:
http://mdausa.org/disease/friedreichs-ataxia
Accessed May 20, 2013.

Friedreich’s ataxia fact sheet. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/friedreichs_ataxia/detail_friedreichs_ataxia.htm
Updated August 16, 2011. Accessed May 20, 2013.

Koeppen AH. Friedreich’s ataxia: pathology, pathogenesis, and molecular genetics. J Neurol Sci. 2011;303(1-2):1-12.

Wilson RB. Therapeutic developments in Friedrich ataxia. J Child Neurol. 2012;27(9):1212-1216.