Student Evaluation
Strength as Manager
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.