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All info from Reporter and Interpreter.
A longer differential suggests outside reading.
The differential for progressive cerebellar ataxia is very
large. Testing should be done in series rather than all at
once starting with potentially treatable and more common diseases.
I suggest we start with head MRI to consider cerebellar tumor
and multiple sclerosis although the symmetry of findings goes
against these two diseases. Other tests to consider for MS
include CSF and evoked potentials. If no answer is found with
the MRI and follow-up studies, we should consider B12 defic.,
Vit E defic, anti-GAD Abs, neuroacanthocytosis, mitochondrial
disease, paraneoplastic disease (usually more subacute), alcohol
toxicity, cocaine induced vasculopathy, celiac disease, prion
disease (usually more subacute), Friedreich ataxia (FA), and
the spinocerebellar ataxias (SCAs).
At this time I do not feel there is treatment to offer.
We should discourage using alcohol and other drugs.
Examples
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