A JOURNAL OF NEUROLOGY SCIENTIFIC COMMENTARIES Autonomic failure in CANVAS syndrome

This scientific commentary refers to ‘Autonomic dysfunction is a major feature of cerebellar ataxia, neuropathy, vestibular areflexia ‘‘CANVAS’ ’ syndrome’, by Wu et al. (doi: 10.1093/ brain/awu196). A series of papers published in the 1990s by the Bronstein group triggered—albeit unintentionally—intensified research into a clin-ical syndrome characterized by a combination of selective bilateral vestibulopathy and cerebellar ataxia (Bronstein et al., 1991; Waterston et al., 1992; Rinne et al., 1995). The term ‘cerebellar ataxia, neuropathy, vestibular areflexia syndrome ’ (CANVAS) was subsequently coined in 2011 by Szmulewicz and colleagues, fol-lowing a retrospective analysis of case records of patients with cerebellar ataxia and bilateral vestibulopathy with an impaired visually enhanced vestibulo-ocular reflex (Szmulewicz et al., 2011). The latter reflects a combined failure of all three compen