Peripheral Neuropathies That Cause Sensory Ataxia

Common Causes of Sensory Ataxic Neuropathies

Vitamin B12 deficiency causes impaired proprioception and sensory ataxia due to damage to dorsal columns and peripheral nerves, as recommended by the British Medical Association 1, 2
Vitamin E deficiency is associated with cerebellar atrophy and sensory ataxia, according to the American College of Radiology 3
Sensory variants of Guillain-Barré syndrome, including Miller Fisher syndrome, are characterized by ataxia, areflexia, and ophthalmoplegia, as stated by the National Institute of Neurological Disorders and Stroke 4, 5
Chemotherapeutic agents, such as platinum compounds and taxanes, can cause dorsal root ganglion damage and sensory axonal neuropathy, as reported by the American Society of Clinical Oncology 6
Proteasome inhibitors, like bortezomib, can cause predominantly sensory neuropathy with potential proprioceptive involvement, according to the European Hematology Association 7

Balance issues and falls due to impaired proprioception are common symptoms, as noted by the British Medical Association 1, 2
Sensory loss in a "glove and stocking" distribution is a characteristic feature, as described by the American Society of Clinical Oncology 6
Reduced or absent deep tendon reflexes are often observed, as reported by the European Hematology Association 7
A positive Romberg test is indicative of sensory ataxia, as stated by the American College of Radiology 9

Laboratory testing, including vitamin B12 levels and autoimmune panels, is essential for diagnosis, as recommended by the British Medical Association 1, 2
Electrophysiological studies, such as nerve conduction studies, can help confirm the diagnosis, as reported by the European Hematology Association 7
Neuroimaging, including MRI of the brain and spinal cord, can exclude central causes, as stated by the American College of Radiology 3, 9

Treatment depends on the underlying cause, with vitamin B12 supplementation being effective for deficiency, as recommended by the British Medical Association 1, 2
Immune-mediated causes may require IVIG, plasmapheresis, or corticosteroids, as reported by the National Institute of Neurological Disorders and Stroke 4 and the American Society of Clinical Oncology 10
Medication-induced causes may require dose reduction or discontinuation of the offending agent, as stated by the American Society of Clinical Oncology 6 and the European Hematology Association 7