Objective: To determine whether treatment with physostigmine can improve the conditions of patients with ataxia.
Design: A double-blind crossover study with physostigmine was performed in 19 patients with degenerative cerebellar diseases.
Setting: Patients were selected from an ongoing prospective follow-up study at the university hospital in Lübeck, Germany.
Patients: Eleven patients with autosomal dominant cerebellar ataxia and 8 patients with idiopathic cerebellar ataxia.
Intervention: Physostigmine was administered by using a transdermal system (patch) containing 30 mg of physostigmine as a base, of which about 6 mg is released during 24 hours along a diffusion gradient. Each treatment phase with the physostigmine patch or the placebo lasted 4 weeks, after which the treatment of patients was crossed over to the other phase.
Main outcome measures: Ataxia was documented and quantified by using a clinical score and posturographic measures.
Results: Physostigmine patches had no significant effect on cerebellar symptoms.
Conclusion: Treatment with physostigmine does not improve the conditions of patients with ataxia.