Cerebellar ataxia in the Philippines: a scoping review of reported cases and practical approach

Cerebellar ataxia is characterized by incoordination and decomposition of movements, manifesting as gait instability, limb incoordination, oculomotor dysfunction, and scanning dysarthria. Ataxias may be acquired or genetic. Currently, there is a paucity of published data among Filipinos. Herein, we review the etiologies of ataxia published in the literature and discuss the current state of ataxia work-up and management in the Philippines. A literature search was conducted in March 2026 using the search terms: ataxia OR cerebellar oculomotor abnormality OR scanning speech AND ((Philippines[Affiliation]) OR Filipino OR Philippines) in PubMed, Google Scholar, and in a local research index (Health Research and Development Information Network [HeRDIN]). The search yielded 42 unique articles, most of which were case reports/case series, and a few were part of large cohorts. Acquired ataxias were limited to case reports of autoimmune, toxic, infectious, post-infectious, prion-related, and degenerative causes. Case series of genetic forms of ataxias were mostly the autosomal dominant forms (SCA2, SCA7, SCA13, and SCA27A), with some autosomal recessive forms AVED, ataxia-telangiectasia, Wilson disease, two neurodevelopmental syndromes (ZMYND11-related syndromic intellectual disability, Angelman syndrome), and one mitochondrial ataxia (MERRF). The low number of published cases was likely due to under-recognition or underreporting, given the inaccessibility of workup in most areas outside large cities, the lack of local genetic testing services for confirmatory diagnosis, limited healthcare coverage for ataxias, and a lack of movement disorder neurologists/movement disorder centers. We highlight the absence of national‑level registries and limited access to advanced diagnostics, which likely contribute to substantial underrecognition and underreporting of ataxia in the Philippines. We have also proposed an algorithm for the diagnosis and management of ataxia in low-resource settings.