Onset is usually between the ages of 4 and 16 years (but occasionally between 18 months and 50 years). The first symptom is usually gait ataxia or difficulty in walking.
The ataxia gradually worsens and spreads but the arms may remain relatively unaffected for a long period. The legs are most commonly affected, so that individuals often have to use a wheelchair in the advanced stages of the condition. There is often loss of position sense in the hands and feet. Individuals who develop FA at a young age may also develop skeletal problems such as curvature of the spine (called scoliosis) or high-arched feet (called pes cavus).
Dysarthria (slowness and slurring of speech) and dysphagia (problems with swallowing) can develop and become progressively worse. Individuals with FA often have abnormal eye movements (called nystagmus) and some may develop hearing and visual loss.
Various forms of heart disease can accompany FA, particularly thickening of the heart muscle (hypertrophic cardiomyopathy) which can cause problems with the pumping power of the heart and irregularities of heart rhythm (arrhythmias). Diabetes may also develop (see entry Diabetes Mellitus).