Symptoms generally begin in childhood and before puberty. Abnormal muscle control and tone lead to spinal changes and scoliosis or kyphoscoliosis may develop. Heart disease may develop and progress into heart failure . Death may result from heart failure or dysrhythmias that will not respond to treatment. Genetic counseling is recommended for prospective parents with a family history of Friedreich ataxia .
Treatment is based on controlling symptoms and maintaining general health.
Physical activity is encouraged. Physical therapy may be beneficial. Safety must be considered when there is loss of balance and loss of sensation . Safety measures may include use of railings, walkers, or other appliances. The prevention of injury to a body part with decreased feeling may include testing bath water to prevent burns , visual inspection of the body part to check for injuries, use of protective shoes, helmets, or other measures.