Usually, ataxia first affects the legs and torso, causing frequent tripping, poor performance in sports, or just an unsteady walk. Balance and coordination continue to decline over time, and muscles in the legs become weak and easily tired, making it increasingly difficult to walk.
Several years later, people with FA may have difficulty with speech, and their words might come out in a slow, jerky pattern. This problem, known as dysarthria, is caused by incoordination and weakness of the tongue and other facial muscles, not by an impairment of language skills or intellect.
Someone with the “typical” form of FA might begin using a wheelchair anytime between five and 15 years after disease onset. Some people with FA also develop swallowing difficulties, which can allow food to enter the airway, and cause choking or respiratory infections.
Many people with FA who’ve lost the ability to walk maintain their upper-body strength and coordination for several years afterward. Later in the disease, ataxia, and weakness of the arms and hands may interfere with the performing of fine manual tasks like writing or manipulating buttons and zippers. Spasticity (muscle tightness) is not an uncommon complaint of people with FA and may be especially prominent in late-onset cases.