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Final Program


Final Program

Spasticity / Movement Disorders

517 - Rehabilitation Considerations in a Case of Spinocerebellar Ataxia

Friday, February 20, 2026
5:00 PM - 6:30 PM AST
Case Diagnosis: Spinocerebellar Ataxia Type 3 (SCA 3)

Case Description: 70-year-old veteran with lumbar degenerative disc disease and spinal stenosis was admitted to Veterans Affairs (VA) with right leg pain and weakness. Subsequent imaging revealed significant degeneration from L2-L4, most severe at L4 – L5.  The veteran had been noted to have profound ataxia for which he was followed by outpatient neurology service. He was also noted to have dysarthria and vision impairment. There was concern for spinocerebellar ataxia, however, the veteran had not completed imaging or genetic testing. He was started on gabapentin with improvement in pain. He was admitted to the inpatient rehab unit for aggressive therapies including physical therapy, occupation therapy, and speech therapy and genetic testing confirmed SCA3 diagnosis. He was discharged to independent living with assistive devices and home nursing.  

Discussions: Spinocerebellar ataxia (SCA) is a group of progressive neurodegenerative diseases of autosomal dominant inheritance. Over 30 subtypes have been identified with the most prevalent form being type 3. SCA presents between ages 30-50 with slowly progressive symptoms of cerebellar ataxia including: incoordination of gait, hand, speech, and eye movements. Literature shows it is essential patients participate in an intensive, multidisciplinary rehabilitation program focused on improving balance, coordination, and functional independence. 

Conclusions: This case emphasizes the importance of the physiatrist in coordinating cares for complex neurological diagnoses to promote return to a modified independence level. In this patient population, it is important to address safety, continuity of care, and maintenance of functional gains upon discharge.  This includes ongoing PT, OT, and speech for those with dysarthria, social work for coordination of community resources, potential home modifications/assistive devices, and continued education on ataxia and the ways to maintain a high quality of life.