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Neurological Rehabilitation

Role and Impact of Physiatry in a Case of Suspected Spinocerebellar Ataxia

Thursday, October 23, 2025
5:00 PM - 6:30 PM MT
Location: Open Kiosks

    Poster Presenter(s)

  • Eileen Lu, DO

    Resident Physician
    State University of New York (SUNY) Downstate Health Sciences Univ PM&R Program
    Brooklyn, New York

    • Co-Author(s)

  • HP

    Henna Purewal, Other

    Medical Student
    University of Rochester Medical Center
    Rochester, New York

  • Verda S. Mirza, DO

    Resident physician
    State University of New York (SUNY) Downstate Health Sciences Univ PM&R Program
    Brooklyn, New York

  • GK

    Getahun Kifle, MD

    Asst. Prof
    SUNY Downstate
    Brooklyn, New York

  • SA

    Sanjeev Agarwal, MD

    Program Director
    SUNY Downstate Health Sciences University
    Brooklyn, New York

Disclosure(s):
Eileen Lu, DO: No financial relationships to disclose
Verda S. Mirza, DO: No financial relationships to disclose
Sanjeev Agarwal, MD: No financial relationships to disclose
Case Diagnosis: A 24 year-old female with gait abnormality.

Case Description or Program Description: The patient was referred by her primary physician for further evaluation of abnormal gait. She endorsed history of tremors affecting her upper extremities and head, which were worsening over the last decade. She endorsed family history of similar signs and symptoms on her maternal side in addition to cardiac problems. She was previously diagnosed with benign familial tremor and was on propranolol with mild-moderate efficacy. Prior magnetic resonance imaging (MRI) demonstrated diffuse cerebellar volume loss. On examination, she had metatarsal hypoplasia, mild scissoring ataxic gait, genu recurvatum, joint hyperlaxity with Beighton score of 4 (hyperextension of bilateral knees and 5th metacarpophalangeal joint), head titubation with dysarthria, and bilateral dysmetria with overshooting and dysdiadochokinesia.

Setting: Outpatient PM&R Clinic

Assessment/Results: The patient was referred to physical therapy for gait ataxia and to neurology and genetics for further workup. The physical therapy sessions focused on hamstring and calf stretches, heel and toe raises, hip abductions, partial squats, forward lunges, and side steps. After 4 weeks of therapy, she reported substantial improvement in her symptoms. On follow-up ten months later, she endorsed subjective improvement in gait stability and is currently undergoing panel testing for spinocerebellar ataxia.

Discussion (relevance): Currently, there are no approved treatments of spinocerebellar ataxia. However, common off-label medications that have been trialed include buspirone, amantadine, and riluzole which potentially have cerebellar modulatory effects. Treatments are also individualized based on symptoms such as propranolol for tremors or baclofen for spasticity. In addition to pharmacologic agents, supportive therapies including physical, occupational, and speech therapy are indicated and can provide significant benefit towards physical and psychological well-being.

Conclusions: Rehabilitation is a central palliative component in management of movement disorders including spinocerebellar ataxia.