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Drug-induced ataxia
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Drug-induced ataxia

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Contributors: Christine Osborne MD, Richard L. Barbano MD, PhD
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Synopsis

Medications and toxins can lead to transient or permanent cerebellar ataxia. A thorough medication history should be obtained in ataxia patients without a readily apparent cause. Commonly implicated medications include:
  • Phenytoin – May cause nystagmus at therapeutic doses, but ataxia is common with supratherapeutic levels. Effects are typically reversible with medication cessation, but permanent cerebellar degeneration can occur with chronic administration.
  • Antiepileptic drugs – Carbamazepine, oxcarbazepine, lacosamide, lamotrigine, rufinamide and zonisamide, benzodiazepines, ezogabine, felbamate, and phenobarbital may cause cerebellar ataxia.
  • Valproic acid – May cause cerebellar ataxia in the setting of hyperammonemia.
  • Chemotherapeutic agents – High-dose cytarabine and asparaginase may cause either permanent or reversible ataxia during medication administration. Acute cerebellar ataxia does not typically occur with fluorouracil administration, but may occur weeks to months after completion of therapy.
  • Alcohol – Most common toxin producing ataxia in a midline cerebellar pattern, characterized by ataxia of the legs and gait with relative sparing of the arms.
  • Other toxins and poisons – Carbon tetrachloride, heavy metals, phencyclidine (PCP), and toluene may cause cerebellar ataxia.

Codes

ICD10CM:
R27.0 – Ataxia, unspecified

SNOMEDCT:
20262006 – Ataxia

Differential Diagnosis & Pitfalls

Best Tests

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Updated: 03/13/2018
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Drug-induced ataxia
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Drug-induced ataxia : Ataxia
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