 1. History and physical; 2. Electrocardiogram EKG; 3. Dobutamine stress echocardiogram; 4. High-resolution computed tomography of the chest HRCT; 5. Blood draw for laboratory tests- these tests will include a complete blood count, evaluating liver and kidney function, assessing immune system, tissue typing, and checking for certain germs that can cause infections, including a pregnancy test for females and prostate-specific antigen PSA for male as well as testing for HIV; 6. Pulmonary Function Test PFT; 7. Electromyography EMG; 8. Magnetic Resonance Imaging MRI of the Abdomen and Pelvis; 9. Magnetic Resonance Imaging MRI of the Spinal Cord; 10. Magnetic Resonance Imaging MRI of the Brain with Gadolinium only if PERM of cerebellar ataxia; 11. Colonoscopy; 12. Mammogram if female; 13. Timed ambulation; 14. Quality of Life Questionnaires Short Form 36 Health Survey SF36 and Barthel Index; 15. Chronic Pain Acceptance Questionnaire CPAQ;16. Rankin Functional Scale; 17. Modified Ashworth Scale;18. PCA-1, PCA-2 antibody only if cerebellar ataxia; 19. Spinocerebellar ataxia SCA 1, 2, 3, 4, 5, 6, 7, 8 genes only if ataxia 