Hemogram, blood electrolyte levels, and liver function test results were normal. Serum angiotensin-converting enzyme, vitamin B12, vitamin E, thyroid-stimulating hormone, ceruloplasmin, and serum protein electrophoresis levels were normal. The results of tests for antinuclear antibody, human immunodeficiency virus, rapid plasma reagin, antigliadin IgG and IgA, paraneoplastic antibody, anti–glutamic acid decarboxylase antibody, urine heavy metal, and a complete genetic ataxia panel (including analysis for spinocerebellar ataxia [SCA] types 1, 2, 3, 5, 6, 7, 10, 12, 13, 14, 17, and 28 and frataxin) were all negative or normal. Leukocyte arylsulfatase A (ARSA) activity was decreased at 2.4 U (reference range, >2.5 U). The creatine kinase level was mildly elevated at 219 U/L (to convert to microkatals per liter, multiply by 0.0167).