National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Spinocerebellar ataxia 4



Other Names:
SCA4; Spinocerebellar ataxia type 4; Spinocerebellar ataxia autosomal dominant with sensory axonal neuropathy
Categories:
This disease is grouped under:

Spinocerebellar ataxia 4 (SCA4) is a very rare form of hereditary progressive movement disorder. Symptoms include muscle weakness (atrophy) and difficulty coordinating body movements (ataxia), most notably causing a jerky, unsteady walking style (gait) and difficulty speaking (dysarthria).[1][2] A distinctive feature of SCA4 is the progressive loss of feeling or sensation in the hands and feet (peripheral neuropathy) and loss of reflexes.[3] Degeneration of the area of the brain controlling balance and movement (cerebellar atrophy) causes symptoms to worsen over decades.[4] The symptoms of SCA4 typically begin during the fourth or fifth decade of life, but can begin as early as the late teen years.[5]. SCA4 is inherited in an autosomal dominant manner. Although SCA4 has been linked to a location on chromosome 16, (16q22.1), the gene which causes SCA4 when mutated has not been found.[6] Diagnosis is based on symptoms consistent with the disease. Although there is no cure, treatment options may include physical therapy, assistive devices, and medications depending on the type and severity of symptoms present. 
Last updated: 7/24/2016

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
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HPO ID
80%-99% of people have these symptoms
Absent Achilles reflex
Absent ankle reflexes
0003438
Impaired proprioception 0010831
Impaired tactile sensation
Impaired touch sensation
0010830
Impaired vibratory sensation
Decreased vibration sense
Decreased vibratory sense
Diminished vibratory sense
Impaired vibratory sense
[ more ]
0002495
30%-79% of people have these symptoms
Ataxia 0001251
Dysarthria
Difficulty articulating speech
0001260
Gait disturbance
Abnormal gait
Abnormal walk
Impaired gait
[ more ]
0001288
Motor deterioration
Progressive degeneration of movement
0002333
5%-29% of people have these symptoms
Motor axonal neuropathy 0007002
Sensory axonal neuropathy 0003390
Percent of people who have these symptoms is not available through HPO
Areflexia
Absent tendon reflexes
0001284
Autosomal dominant inheritance 0000006
Babinski sign 0003487
Cerebellar atrophy
Degeneration of cerebellum
0001272
Distal sensory impairment
Decreased sensation in extremities
0002936
Hyporeflexia
Decreased reflex response
Decreased reflexes
[ more ]
0001265
Impaired smooth pursuit 0007772
Limb dysmetria 0002406
Progressive cerebellar ataxia 0002073
Sensory neuropathy
Damage to nerves that sense feeling
0000763
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Last updated: 7/1/2020

Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources


If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • The Centers for Mendelian Genomics program is working to discover the causes of rare genetic disorders. For more information about applying to the research study, please visit their website.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease


Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Financial Resources


These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Spinocerebellar ataxia 4. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.


  1. Thomas Bird. Autosomal Dominant Hereditary Ataxia. National Organization for Rare Disorders; 2014; http://rarediseases.org/rare-diseases/autosomal-dominant-hereditary-ataxia/.
  2. Cassandra L. Kniffin and Victor A. McKusick. Spinocerebellar Ataxia 4; SCA4. Online Mendelian Inheritance in Man; September 20,2011; http://www.omim.org/entry/600223.
  3. Bird TD. Hereditary Ataxia Overview. GeneReviews; March 3, 2016; http://www.ncbi.nlm.nih.gov/books/NBK1138/.
  4. Hellenbroich Y1, Gierga K, Reusche E, Schwinger E, Deller T, de Vos RA, Zühlke C, Rüb U.. Spinocerebellar ataxia type 4 (SCA4): Initial pathoanatomical study reveals widespread cerebellar and brainstem degeneration.. Journal of Neural Transmission; July 2006; 113(7):829-843. https://www.ncbi.nlm.nih.gov/pubmed/16362839.
  5. Flanigan K1, Gardner K, Alderson K, Galster B, Otterud B, Leppert MF, Kaplan C, Ptácek LJ. Autosomal dominant spinocerebellar ataxia with sensory axonal neuropathy (SCA4): clinical description and genetic localization to chromosome 16q22.1. American Journal of Human Genetics; August 1996; 59(2):392-399. https://www.ncbi.nlm.nih.gov/pubmed/8755926.
  6. Edener U1, Bernard V, Hellenbroich Y, Gillessen-Kaesbach G, Zühlke C. Two dominantly inherited ataxias linked to chromosome 16q22.1: SCA4 and SCA31 are not allelic. Journal of Neurology; July 2011; 258(7):1223-1227. https://www.ncbi.nlm.nih.gov/pubmed/21267591.