Patients presenting with ataxic symptoms should be referred to secondary care, where they should ideally be seen by a paediatrician, if under 16, or adult neurologist. Depending on the clinical state of the patient, this referral may need to be urgent. For example, in a case with a suspected brain tumour, the patient may have to be admitted or seen within two weeks. In children, following referral to a paediatrician, the recommended pathway then involves being referred to a paediatric neurologist.

A referral to a neurology centre specialising in ataxia is then recommended particularly for patients where a diagnosis of the cause of ataxia has not been achieved. In selected cases (adults) it may be possible for the general practitioner (GP) to refer directly to Specialist Ataxia Centres (eg: in cases where a diagnosis of a progressive ataxia has already been made).

There are currently three Specialist Ataxia Centres in the UK accredited by Ataxia UK. These are centres specifically involved in the diagnosis and management of patients with progressive ataxia22. Patients attending these Accredited Specialist Ataxia Centres would be seen by an ataxia specialist neurologist, receive continuity of care, support by a specialist nurse and streamlined referrals to other named specialists as appropriate. The service provided is highly valued by patients (data from London Specialist Ataxia Centre, Ataxia UK). A list of these Accredited Specialist Ataxia Centres is found in the Appendix. In addition the Appendix also lists other clinicians with expertise in ataxia in the UK.

This information is taken from Management of the ataxias - towards best clinical practice third edition, July 2016. This document aims to provide recommendations for healthcare professionals on the diagnosis and management of people with progressive ataxia. To view the full document, including references, click here.