**7. Treatment and management**

Specific interventions include steroids for paraneoplastic and other immunological disorders as well as immunomodulatory therapies for steroid-responsive encephalopathy associated with Hashimoto's encephalopathy. General measures include eliminating toxins, compensating metabolic states, and treating deficiency disorders [29].

### *Introductory Chapter: Insights into Ataxia DOI: http://dx.doi.org/10.5772/intechopen.113755*

Pharmacological agents of the nonspecific type include amantadine, alpha lipoic acid, buspirone, branched-chain amino acids, creatine, coenzyme Q10, vitamin E, physostigmine, riluzole, and selective serotonin reuptake inhibitors. Specific agents include acetazolamide used for AS2, ACS type 6, and varenicline for spinocerebellar ataxia. Bile acid replacement may be attempted for cerebrotendinous xanthomatosis. Diets such as gluten-free are indicated for gluten ataxia.

Cerebellar tremor may improve with the use of antiepileptic drugs, oscillopsia with memantine and GABA agonists, and spasticity with antispasticity-type medications [30].

A multidisciplinary approach to ataxic disorders may be necessary due to the variability and progressiveness of motor symptoms and non-motor symptoms. Rehabilitation therapies should be offered to all patients with ataxia. Continuous exercise programs have been shown to be effective with positive results [32].

The proposed outline summarizes all potential symptoms clinicians may need to address when facing an ataxic patient. Treatment strategies are often derived from other neurological conditions with similar symptoms and often work. For example, the approach to treating spasticity and bladder symptoms is the same as for people with multiple sclerosis. Assessment and management of these complications are best accomplished with the involvement of therapy specialists, and multidisciplinary teamwork can greatly improve patient care. Carrying out speech therapy is fundamental in the patient's management, including monitoring the swallowing function in the initial stages and seeking to avoid complications while trying to plan nutrition through alternatives such as percutaneous gastrostomy and others (**Figure 1**) [30, 32–34].
