Pathophysiological changes in hereditary ataxia (HA) and the corresponding treatments. This diagram depicts various pathophysiological alterations in ataxia and suggests treatments that address specific pathways. The proposed pharmacological strategies aim to regulate excitability and calcium homeostasis, (i.e., Riluzole, Amantadine, and Varenicline) as well as target proteostasis, mitochondrial dysfunction, and inflammation, with the recently FDA-approved drug Omaveloxolone. Additionally, alternative therapeutic methods like antisense oligonucleotides and gene therapy can address distinct pathways within the proposed framework.