6. Work-up for ataxia depends on the differential diagnosis. Neuroi magi ng
(CT acutely, but MRI is better for chronic symptoms) is necessary if a focal lesion
is suspected . Acute, nonfocal ataxia warrants testing for alcohol and drug intoxkation
. In patients with known malignancy, work-up for metastases (CT/MRI)
and paraneoplastic syndromes (autoantibodies) should be considered . Lum bar
puncture should be performed i n cases where C N S infection is l i kely (fever,
meningismus). Patients with primarily sensory ataxia should be eval uated for
causes of sensory neu ropathy and dorsal col u m n pathology by checking
VDRL/RPR, glucose, and vita m i n 81 2.