title: An approach to the patient with late-onset cerebellar ataxia.
abstract: BACKGROUND
  An 83-year-old man presented with hypertension, hyperlipidemia, and a previous basal cell carcinoma, having developed progressive worsening of his balance and difficulty walking at the age of 78 years. He was initially diagnosed with stroke, but MRI revealed only isolated cerebellar atrophy. The patient then underwent multiple evaluations for an underlying paraneoplastic process, all of which were negative, but his symptoms progressed and he remained undiagnosed for several years.
  
  
  METHODS
  Neurological examination, laboratory blood tests, MRI, and directed genetic testing.
  
  
  METHODS
  Five years after becoming symptomatic, the patient was re-evaluated for a possible genetic ataxia syndrome, which was subsequently confirmed by gene testing as spinocerebellar ataxia type 6 (SCA6).
  
  
  RESULTS
  Symptomatic medical treatment and physical, occupational, and speech therapy.
authors.affiliation: Department of Neurology, University of California, Los Angeles, CA 90095, USA.
authors.forename: Brent L
authors.initials: BL
authors.lastname: Fogel
authors.forename: Susan
authors.initials: S
authors.lastname: Perlman
mesh_terms: D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000379:methods; D013132:Spinocerebellar Degenerations / Q000150:complications / Q000235:genetics / Q000473:pathology / Q000628:therapy