Acute cerebellar ataxia
Acute cerebellar ataxia is a neurological disorder characterized by a sudden loss of coordination, particularly affecting the trunk, arms, and legs due to dysfunction in the cerebellum, the brain region responsible for balance and coordination. This condition is most commonly observed in young children and often follows viral infections, such as chickenpox, but can also arise from various toxins, infections, or structural abnormalities in the brain. Symptoms may include unsteady movements, clumsiness, speech difficulties, and abnormal eye movements, alongside potential nausea and behavioral changes. Diagnosis typically involves physical assessments and various imaging or laboratory tests to rule out other conditions. Treatment options are limited; while most cases resolve spontaneously within months, some may require addressing underlying causes or managing persistent symptoms through medications or therapy. There are no preventive measures for acute cerebellar ataxia, although vaccinations against certain viral infections can reduce risk factors.
Acute cerebellar ataxia
- ANATOMY OR SYSTEM AFFECTED: Brain, muscles, nervous system
- ALSO KNOWN AS: Cerebellitis
Definition
Acute cerebellar ataxia is a disorder of the nervous system marked by the sudden onset of a disturbance in muscle coordination, especially in the trunk, arms, and legs. The cerebellum, the part of the brain that controls balance and coordination, does not function properly in the case of cerebellar ataxia. Although the abnormality of the limbs is most often noticed, the disorder also can cause abnormal eye movements. Nausea and vomiting may also occur as part of the disorder.
While it can occur at any age, acute cerebellar ataxia is most common in young children. It can occur several weeks after a viral infection, such as chickenpox. Most cases disappear without treatment in a matter of months. However, recurrent or chronic progressive cerebellar ataxia does occur.
Causes
Causes of acute cerebellar ataxia include viral infections such as chickenpox, coxsackie disease, Epstein-Barr virus, Mycoplasma pneumonia, human immunodeficiency virus (HIV), and Lyme disease; exposure to insecticides called organophosphates and exposure to certain toxins, such as lead, mercury, thallium, and alcohol; cerebellar hemorrhage; abscess; blood clot; and obstruction of an artery. Causes of recurrent or chronic acute ataxia include stroke, malformation of the cerebellum, multiple sclerosis, migraine or vertigo, genetic or metabolic disorders, brain tumor, alcoholism, and seizures.
Risk Factors
Several factors increase the chance of developing acute cerebellar ataxia. These factors include viral infections, recent vaccination, and exposure to certain insecticides, drugs, or toxins. Children three years of age or younger are especially at higher risk.
Symptoms
Symptoms of acute cerebellar ataxia include uncoordinated movements of the limbs or trunk; clumsiness with daily activities; difficulty walking (unsteadiness); speech disturbances, including slurred speech and changes in tone, pitch, and volume; visual complaints; and abnormal eye movements. Accompanying symptoms may include headache, dizziness, changes in mental state (such as personality or behavioral changes), chaotic eye movement, and clumsy speech patterns.
Screening and Diagnosis
A doctor will observe limb coordination to assess the degree and nature of the ataxia. Further tests may include examination of cerebrospinal fluid, a magnetic resonance imaging (MRI) scan (a scan that uses radio waves and a powerful magnet to produce detailed computer images), a computed tomography (CT) scan (a detailed x-ray picture that identifies abnormalities of fine tissue structure), metabolic blood tests, ultrasound (a test that uses sound waves to examine the head), and urinalysis.
Tests to detect other possible diseases that are causing the symptoms include a nerve conduction study (measures the speed and degree of electrical activity in a nerve to determine if it is functioning normally) and electromyography (EMG; measures and records the electrical activity that muscles generate at rest and in response to muscle contraction).
Treatment and Therapy
There is no treatment for acute cerebellar ataxia. Ataxia usually disappears within a few months without treatment. For cases in which an underlying cause is identified, a health+care provider will treat that cause. In extremely rare cases, the patient may have continuing and disabling symptoms. Treatment includes corticosteroids, intravenous immunoglobulin, and plasma exchange therapy. Drug treatment to improve muscle coordination has a low success rate. However, the following drugs may be prescribed: clonazepam (such as Klonopin), amantadine (such as Symmetrel), gabapentin (such as Neurontin), and buspirone (such as BuSpar). Occupational or physical therapy might also alleviate a lack of coordination, as might diet changes and nutritional supplements.
Prevention and Outcomes
Acute cerebellar ataxia cannot be prevented. However, children can receive vaccines against the viral infections that increase the risk of getting acute cerebellar ataxia.
Bibliography
"Acute Cerebellar Ataxia." Medline Plus, 23 Jan. 2023, medlineplus.gov/ency/article/001397.htm#. Accessed 3 Feb. 2025.
Berman, P. “Ataxia in Children.” International Pediatrics 14 (1999): 44–47.
Bradley, Walter G., et al., eds. Neurology in Clinical Practice. 5th ed. Philadelphia: Butterworth Heinemann/Elsevier, 2007.
MedLink. “Acute Cerebellar Ataxia in Children.” Available at http://www.medlink.com.
Ropper, A. H., and R. H. Brown. Adams and Victor’s Principles of Neurology. 8th ed. New York: McGraw-Hill Medical, 2005.
Stumpf, D. A. “Acute Ataxia.” Pediatrics in Review 8 (1987): 303–306.