“…Ataxia, however, never occurs in isolation. Numerous other clinical problems reflect progressive dysfunction in the brainstem, oculomotor system, pyramidal and extrapyramidal pathways, lower motor neurons and peripheral nerves (Sequeiros and Coutinho, 1993; Takiyama et al, 1994; Cancel et al, 1995; Sasaki et al, 1995; Durr et al, 1996; Matsumura et al, 1996; Schols et al, 1996; Soong et al, 1997; Zhou et al, 1997; Watanabe et al, 1998; Friedman, 2002; Lin and Soong, 2002; Rub et al, 2002a,b; Rub et al, 2003; Rub et al, 2004a,b; Friedman et al, 2003). Most commonly, affected persons present in the young-adult to mid-adult years with progressive gait imbalance accompanied by vestibular and speech difficulties.…”