Slurred speech and difficulty walking, worse over 6 months

Olivopontocerebellar atrophy (OPCA) - spectrum of progressive neurodegenerative diseases of cerebellum and brainstem characterized by progressive balance loss(disequilibrium), progressive impairment of voluntary movements (cerebellar ataxia), and slurred speech (dysarthria).

Sporadic (more common) - Main type is Multisystem Atrophy (MSA) that has transverse demyelinating strip across the pons producing the crossed buns sign. Also Shy-Drager and striatonigral degeneration.

Hereditary - Hereditary spinocerebellar ataxia, autosomal dominant cerebellar ataxia, and Machado-Joseph Disease. Can be autosomal recessive or x linked as well.