====== Neuro-Opthalmic Signs in Children with Ataxia ======
==== Causes of Ataxia ====
  * Hypoxic-Ischemia enchephalopathy
  * Episodic ataxia
  * Neuronal ceroid lipofucinosis
  * [[joubert_syndrome|Joubert syndrome]]
  * Neuronal migration disorder
  * Ischemic stroke
  * Friedreich ataxia
  * Mitochondrial Disease
  * Severe epilepsy
  * Ataxia telangiectasia
  * [[angelman_syndrome|Angelman syndrome]] 


==== Common Associations ====
^ Neuronal-ophthalmic Finding  ^ Frequency  ^
|**Afferent**                            ||
| Decreased visual acuity      | 9%         |
| Abnormal optic discs         | 9%         |
| Abnormal pupils              | 3%         |
| Abnormal Visual Fields       | 1%         |
|**Efferent**                |            |
| Strabismus                   | 30%        |
| Pathologic nysagmus          | 28%        |
| Gaze evoked nystagmus        | 15%        |
| Impaired smooth pursuit      | 23%        |
| Hypometric saccades          | 10%        |
| Hypermetric saccades         | 2%         |
| Impaired Ductions            | 2%         |


^ Ataxia Disorder                  ^ Most Common Association  ^
| Hypoxic-Ischemic encephalopathy  | Strabismus               |
| Episotic ataxia                  | Nystagmus                |
| Neuronal ceroid lipofuscinosis   | Abnormal Optic discs     |
| Joubert Syndrome                 | Strabismus               |
| Neuronal Migration Disorder      | Strabismus               |
| Ischemic Stroke                  | Nystagmus                |
| Friedreich Ataxia                | Impaired Saccades        |
| Mitochondrial Disease            | Strabismus/Nystagmus     |
| Severe epilepsy                  | Decreased Visual acuity  |
| Ataxia Telangiectasia            | Impaired smooth pursuit  |
| Angelman Syndrome                | Strabismus               |
- Adapted from Salman et. al. Neuroophthalmology. 2015;39(3):125-131

==== References ====

  * {{ ::ataxia_nystagmus_children.pdf |Neuro-Ophthalmological Findings in Children and Adolescents with Chronic Ataxia. Salman MS. and Chodirker BN. Neuroophthalmology. 2015;39(3):125-131}}