Loss of Sensation in Ataxia: How Nerve Damage Affects Your Body

Ataxia is commonly thought of as a movement disorder, but some people also experience loss of sensation in addition to trouble walking. In ataxia, damage to sensory nerves can affect how your body feels touch, pain, and temperature, and how you sense movement, sound, and visual information.

In this article, we’ll explore what causes sensory nerve damage in ataxia, and symptoms involving feeling, body awareness, hearing, and vision.

How Ataxia Affects the Senses

Sensory nerve damage can change how you experience the world, from the ability to feel a light touch or know where your limbs are, to seeing clearly and hearing conversations.

Below are some of the most common ways this shows up in people with ataxia.

Numbness and Loss of Feeling

Certain forms of ataxia are associated with numbness or a loss of sensation.

Depending on the specific type of ataxia, a loss of feeling may start in one region of the body, like the legs, and gradually spread elsewhere, such as the torso or arms, as the disease progresses.

At first, sensory loss may be subtle, leading to trouble feeling vibrations. As nerve damage worsens, it may be harder to feel pain or temperature changes in parts of the body, which could increase the risk of injuries, burns, or infections in areas that are numb.

For some people, the numbness makes it feel like they’re wearing socks or gloves when they’re not.

Because the underlying nerve damage in conditions like Friedreich ataxia is progressive, sensory changes may gradually worsen over time.

Chronic Pain

Nerve damage doesn’t always reduce how much you can feel. Sometimes it causes abnormal sensations instead.

Peripheral neuropathy can lead to tingling, burning, or stabbing sensations.

You may also become extremely sensitive to touch, causing you to feel pain even in activities that shouldn’t be painful. For example, you might have pain in your feet when they’re covered by a blanket.

When nerves are damaged, they can send signals that shouldn’t be sent or make errors that change what the signals mean. Symptoms of neuropathic pain often begin in the feet, since these nerves are the furthest from the brain.

Not everyone with ataxia develops chronic pain, but sensory nerve damage can contribute to pain sensations in some people.

Loss of Body Awareness (Proprioception)

One of the most important sensory functions affected in many forms of ataxia is proprioception.

Proprioception is the body’s ability to sense where in space body parts like the arms, legs, and joints are without looking at them. When your body uses proprioception to move or learn new physical skills, it’s known as kinesthesia.

Together, proprioception and kinesthesia allow you to do everyday tasks like walking over uneven surfaces, eating with utensils, or reaching for an object without constantly watching every movement.

People with sensory ataxia may lose this ability to feel where their body is. In Friedreich ataxia specifically, position sense is often affected early on in the disease.

When proprioception is impaired, the brain can have trouble perceiving body positioning, making it hard to tell the rest of the body how to react. This can lead to balance problems and clumsiness.

With proprioception issues, you might not be able to tell how much force you’re applying, leading you to do things like pressing the pen down too hard while writing, or not using enough pressure. You may also miss objects when you reach for them.

Proprioception may also contribute to gait or walking problems. Without accurate information from the feet and legs, it becomes harder to judge where the body is during movement and how much tension is needed in the muscles to maintain balance.

If you’re having issues around proprioception, your healthcare team may use a Romberg test to help evaluate this.

During a Romberg test, a person stands with their feet together and then closes their eyes. Removing visual input makes the body rely more heavily on proprioceptive signals. If proprioception is impaired, balance may worsen significantly when the eyes are closed.

Vision Changes

Some forms of ataxia can affect vision. In fact, a small portion of people with Friedreich ataxia develop visual impairments. Those with spinocerebellar ataxias may also experience changes in the eyes.

Vision depends on healthy sensory pathways that carry information from the eyes to the brain. When these pathways are affected, people may experience reduced visual function, making everyday tasks more difficult.

As with other types of sensory changes, vision changes vary from person to person. Some individuals may experience vision loss, double vision, unstable or shaky vision, or delayed vision when looking between objects.

Ataxia can also cause vestibular dysfunction, which results in shaky vision while walking.

It’s important to report any new vision symptoms to your healthcare provider, especially if they interfere with your everyday tasks.

Hearing Loss

Hearing is another sensory function that can be affected in some forms of ataxia, particularly Friedreich ataxia.

Research has shown that auditory nerve pathways can be affected in Friedreich ataxia, which may lead to difficulties processing sound.

In some cases, people can hear sounds but have trouble understanding speech, especially in noisy environments. Health experts describe this as an auditory processing problem caused by abnormal transmission of sound signals through the nervous system.

Interventions with listening devices or specific tactics, like lip-reading or reducing background noises, may help people with auditory changes manage challenges. If you notice changes in your hearing or ability to comprehend speech, talk to your doctor.

Recognizing Sensory Symptoms in Ataxia

Sensory nerve damage can impact quality of life for people with ataxia.

If you know what to watch for, you can recognize sensory changes earlier and alert your neurologist. They may order testing, review your treatment plan, and refer you to other specialists such as ophthalmologists or audiologists for more help.

In some cases, physical therapy or occupational therapy may help you function better with proprioception problems. For instance, they may help you learn to use adaptive devices such as canes to compensate for these issues.

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