Table 4. [Treatment of Manifestations in Individuals with Spinocerebellar Ataxia Type 1]. - GeneReviews®

Manifestation/Concern	Treatment	Considerations/Other
Ataxia	Care by physiatrist, OT/PT	Consider adaptive devices to maintain/improve independence in mobility (e.g., canes, walkers, ramps to accommodate motorized chairs), feeding (e.g., weighted eating utensils), & dressing (e.g., dressing hooks). PT (balance exercises, gait training, & coordinative training should be prioritized over muscle strengthening) to maintain mobility & function ¹ OT to optimize ADL Inpatient rehab w/OT & PT may improve ataxia & functional abilities. Weight control to avoid obesity Home adaptations to prevent falls (e.g., grab bars, raised toilet seats)
Dysarthria	Speech/language therapy	Consider alternative communication methods as needed (e.g., writing pads, digital devices).
Dysphagia	Modify food consistency to ↓ aspiration risk. Consider feeding device for those w/recurrent aspiration.	Video esophagram may help define best consistency.
Nutrition assessment: Caloric support may be needed in those w/weight loss. Vitamin supplementation to meet dietary needs
Cognitive/ Psychiatric	Psychotherapy / neuropsychologic rehab	Consider cognitive behavioral therapy.
Standard treatment for psychiatric manifestations (e.g., depression, anxiety, & psychosis)
Pain	Standard pharmacotherapy for pain control Referral to pain mgmt specialist as needed

Manifestation/Concern

Treatment

Considerations/Other

Ataxia

Care by physiatrist, OT/PT

Consider adaptive devices to maintain/improve independence in mobility (e.g., canes, walkers, ramps to accommodate motorized chairs), feeding (e.g., weighted eating utensils), & dressing (e.g., dressing hooks).
PT (balance exercises, gait training, & coordinative training should be prioritized over muscle strengthening) to maintain mobility & function ¹
OT to optimize ADL
Inpatient rehab w/OT & PT may improve ataxia & functional abilities.
Weight control to avoid obesity
Home adaptations to prevent falls (e.g., grab bars, raised toilet seats)

Dysarthria

Speech/language therapy

Consider alternative communication methods as needed (e.g., writing pads, digital devices).

Dysphagia

Modify food consistency to ↓ aspiration risk.
Consider feeding device for those w/recurrent aspiration.

Video esophagram may help define best consistency.

Nutrition assessment:

Caloric support may be needed in those w/weight loss.
Vitamin supplementation to meet dietary needs

Cognitive/
Psychiatric

Psychotherapy / neuropsychologic rehab

Consider cognitive behavioral therapy.

Standard treatment for psychiatric manifestations (e.g., depression, anxiety, & psychosis)

Pain

Standard pharmacotherapy for pain control
Referral to pain mgmt specialist as needed

From: Spinocerebellar Ataxia Type 1

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Adam MP, Feldman J, Mirzaa GM, et al., editors.

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