Sporadic adult-onset spinocerebellar ataxias
Lieto et al.  wrote a very interesting review article entitled “Degenerative and acquired sporadic adult onset ataxia.” The authors summarized, in practical diagnostic approach, the main sporadic adult-onset ataxias including degenerative non-hereditary, hereditary, and acquired ataxias.  This is a very thorough review on the subject; however, we believe that there are some points that deserve further discussion.
In the group of non-hereditary degenerative ataxias, important issues could be discussed. First, in the multiple system atrophy type C, besides the classical cerebellar dysfunction, associated with dysautonomia and also pyramidal signs and parkinsonian and dystonic features, the presence of REM-sleep behavior disorder (RBD) is a very common predictive sign.  The RBD is strongly associated with neurodegenerative diseases, particularly synucleinopathies such as multiple system atrophy (MSA).  Thus, the quantification of REM sleep can be an important...
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