**7. Treatment of childhood ataxias**

Treatment of a child with ataxia depends on the aetiology. One of the most important challenges is to identify the treatable causes. For example, ataxia with vitamin E deficiency (AVED), abetalipoproteinemia, and hypobetalipoproteinemia are treated with vitamin E. Wilson's disease is treated with D-penicillamine and trientine as copper chelators. Some metabolic disorders are treated with dietary modifications, such as glutamate 1 deficiency and pyruvate dehydrogenase deficiency, which are treated with the ketogenic diet. Specific enzymatic treatments have recently been developed for some metabolic disorders, especially focused on slowing down their progression. An example is Miglustat for NPC patients [74].

Physical therapy is an important part of treatment to help maintain mobility as long as possible. Occupational therapy, and speech or language therapy are also part of the symptomatic therapy [86].

There are also reports of some benefits in adults with cerebellar ataxia with transcranial magnetic stimulation [87] and transcranial direct current stimulation [88], but the evidence is still lacking, especially in children.
