Using clinical information for differential diagnosis is used to prioritize genetic testing not as a stand-alone diagnosis. Many potential differentiating symptoms have been found, and methods of assessing many symptoms and their progression to guide genetic testing have been developed. Even if a specific type of spinocerebellar ataxia cannot be immediately determined clinical history, family history, clinical examination can help distinguish between other ataxias and can help reduce the number of genetic tests needed to identify a type of SCA. Examination of relatives of individuals thought to have sporadic ataxia can often reveal enough family history to identify a transmission mode.There are some common trends that may be useful to discriminate SCAs. SCA1 tends to progress faster than SCA2, 3, and 6, with greater annual change in SARA scores and earlier loss of functions after onset. In the diagnostics of clinical ataxia, imaging may not be useful to distinguish SCA1 from other SCAs as there is significant variance between individual cases and significant overlap between diseases. Vestibulo-ocular reflex can be tested using a video recorded head impulse test or vHIT. In this test, SCA1 typically has normal reflex latency, and does not consistently show a deficit in VOR function, distinguishing it from SCA3 and Friedreichs ataxia. Certain patterns in ocular motor disorders, detectable with video-oculography, appear to typify certain SCA types.
Epidemiology
The National Institute of Health reports that SCA1 has a prevalence of approximately 1 or 2 per 100,000 however a review of literature has shown that these estimates vary significantly from study to study and can be less than 1 per 100,000 or as high as 6 per 100,000. Among all types of SCA, SCA1 is among the most common and the portion accounted for by SCA1 varies between geographic regions, with percentages as high as 40% of all SCA diagnoses in populations in Russia and South Africa being SCA1. In the United States SCA1 accounts for 6% of SCA diagnoses. Overall, SCA1 accounts for 6-27% of all cases dominant ataxias. : 6  Because of its late onset, often appearing after reproductive age, SCA1 exerts low selection intensity, ranking about 0.19 on the Crows index, but intensity may vary with time within a population or family, as anticipation increases the number of CAG repeats. One implication of this is that SCA1 is unlikely to disappear from a population by natural selection alone.Prevalence of each type of SCA varies with geographic region and ethnicity, possibly because of founder effects and historic migration patterns. High prevalence regions include central Poland, where 68% of autosomal dominant cerebellar disorders are SCA1; communities in Tamil Nadu, where up to 7.2% of the population has SCA1 in some small villages; the Tohoku region on the northern portion of Honshu Island, with 24.8% of cases being SCA1; and among Yakut populations in eastern Siberia, with a prevalence 46 per 100,000 in rural populations.