Friedreich’s ataxia Home A-Z Health Information Health Library A-Z Friedreich’s Ataxia Overview Friedreich’s ataxia refers to an autosomal recessive condition caused by trinucleotide (GAA) mutation in Frataxin gene. It causes difficulty in walking with imbalance, speech disturbance and multiple systemic complications. Cause Caused by a gene defect that is inherited from both parents. Risk factors Family historyChronic and excessive alcohol intakeHypothyroidism or hypoparathyroidismMultiple sclerosisCeliac diseaseSarcoidosisCancer-triggered paraneoplastic syndromeMultiple system atrophyAnti-seizure sedatives and medicationsExposure to heavy metals (mercury or lead), or solvents (paint thinner)Deficiency of vitamin E, B6, B12, or B1Excess intake of vitamin B-6 Symptoms Pyramidal weaknessGait ataxiaOptic atrophyDeafnessAxonal peripheral neuropathyAltered eye movements- nystagmus, hypometric saccades, macrosaccadic square wave jerks, broken pursuitSkeletal abnormalities: high arched foot, spinal deformities like scoliosisDiabetes or glucose intoleranceECG alterations: widespread T wave inversion Specialist to approach Neurologist Diagnosis Clinical examinationElectrophysiological testing for peripheral neuropathyECG, echocardiogramBlood tests for glucose levels, vitamin E levelsX-ray for scoliosisMRI/ CT scan for brain and spinal cordGenetic testing Treatment Symptomatic treatment, physiotherapy, gait trainingSurgical procedures for ankle contracturesOrthosis and assistive devicesManaging cardiac complicationsNewer therapy: Omaveloxolone (currently not available in India)