THE TREATMENT OF SPINOCEREBELLAR ATAXIAS - FACTS AND HYPOTHESES

Actual therapeutic assays in spinocerebellar ataxias, i.e. in Friedrei ch's ataxia (FA) and olivopontocerebellar atrophy (OPCA) are discussed in relation to (i) the serotoninergic theory; (ii) the excitotoxic ac tion of glutamate; and (iii) cerebrospinal fluid thiamine deficiency i n ataxic patients. Data from the literature show that neurochemical de ficiencies arising from cerebellar damage in both FA and OPCA patients are multiple. Assays of replacement and neuroprotective therapeutics with a single drug have produced controversial data or mildly effectiv e results. Consequently, it is hypothesized that a drug cocktail, i.e. L-5-hydroxytryptophan, thiamine and amantadine hydrochloride, would b e more beneficial. This cocktail proved to be useful in open studies, improving respiratory disorders in FA patients. More powerful inhibito rs of N-methyl-D aspartate receptor channels should be tried initially in animal experiments.