The most common secondary cerebellar ataxias are those caused by toxicity, including alcoholic cerebellar degeneration and drug induced (e.g., lithium, phenytoin, toluene, and anticancer drugs); immune-mediated ataxias, including paraneoplastic cerebellar degeneration, ataxia associated with celiac disease (gluten ataxia) and ataxia with glutamic acid decarboxylase antibodies (anti-GAD); and ataxi