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Acute cerebellar ataxia

Definition

Acute cerebellar ataxia is sudden, uncoordinated muscle movement due to disease or injury to the cerebellum in the brain.

Alternative Names

Cerebellar ataxia; Ataxia - acute cerebellar; Cerebellitis; Post-varicella acute cerebellar ataxia; PVACA

Causes, incidence, and risk factors

Acute cerebellar ataxia in children, especially younger than age 3, may occur several weeks after an illness caused by a virus.

Viral infections that may cause this include chickenpox, Coxsackie disease, Epstein-Barr, and echovirus.

Other causes of acute cerebellar ataxia include:

  • Abscess of the cerebellum
  • Alcohol, medications, and insecticides
  • Bleeding into the cerebellum
  • Multiple sclerosis
  • Strokes of the cerebellum
  • Vaccination

Symptoms

Ataxia may affect movement of the middle part of the body from the neck to the hip area (the trunk) or the arms and legs (limbs).

When the person is sitting, the body may move side-to-side, back-to-front, or both. Then the body quickly moves back to an upright position.

When a person with ataxia of the arms reaches for an object, the hand may sway back and forth.

Common symptoms of ataxia include:

  • Clumsy speech pattern (dysarthria)
  • Repetitive eye movements (nystagmus)
  • Uncoordinated eye movements
  • Walking problems (unsteady gait)

Signs and tests

The doctor will ask if the person has recently been sick and will try to rule out any other causes of the problem. Brain and nervous system examination will be done to identify the areas of the nervous system that are most affected.

The following tests may be ordered:

Treatment

Treatment depends on the cause:

  • If the acute cerebellar ataxia is due to bleeding, surgery may be needed.
  • For a stroke, medication to thin the blood can be given.
  • Infections may need to be treated with antibiotics or antivirals.
  • Steroids may be needed for swelling (inflammation) of the cerebellum (such as from multiple sclerosis)
  • Cerebellar ataxia caused by a recent viral infection may not need treatment.

Expectations (prognosis)

People whose condition was caused by a recent viral infection should make a full recovery without treatment in a few months. Strokes, bleeding, or infections may cause permanent symptoms.

Complications

Movement or behavioral disorders may (rarely) persist.

Calling your health care provider

Call your health care provider if any symptoms of ataxia appear.

References

Houtchens MK, Lublin FD, Miller AE, Khoury SJ. Multiple sclerosis and other inflammatory demyelinating diseases of the central nervous system. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 54.

LaRussa PS, Marin M. Varicella-zoster virus infection. In: Kliegman RM, Stanton BF, St. Geme JW III, et al., eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 245.

Steinlin M. The continuum of parainfectious reactions of the cerebellum in childhood. Neuropediatrics. 2012;43:238-239.

Subramony SH, Xia G. Disorders of the cerebellum, including the degenerative ataxias. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC. Bradley’s Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 72.


Review Date: 2/27/2013
Reviewed By: Luc Jasmin, MD, PhD, Department of Neurosurgery, Cedars Sinai Medical Center, Los Angeles and Department of Anatomy, University of California, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.
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