Table 3. [Treatment of Manifestations in Individuals with Spinocerebellar Ataxia Type 38]. - GeneReviews®

Manifestation/ Concern	Treatment	Considerations/Other
Ataxia	Physical therapy to ameliorate coordination difficulties, especially w/walking	Although no clinical evidence of benefit has been offered thus far, individuals should maintain activity.
Crutches (less often canes) & walkers	To prevent falls
Home adaptations incl grab bars for bathtub or shower chairs, raised toilet seats, & ramps to accommodate motorized chairs, as needed
Dysarthria	Speech-language therapy	Communication devices incl writing pads & computer-based devices may be of benefit.
Video esophagram can identify consistency of food least likely to trigger aspiration.	Weighted eating utensils & dressing hooks help maintain a sense of independence.
Hearing loss	Hearing aids may be helpful in selected cases.	Consider referral to audiologist.
Anxiety	Standard treatment
Family/ Community	Appropriate social work involvement to connect families w/local resources, respite, & support Care coordination to manage multiple subspecialty appointments, equipment, medications, & supplies	Ongoing assessment for need of home nursing

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