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Acute Cerebellar Ataxia


Presentation

  • Characteristic presenting features include fever, relative bradycardia, diarrhea or constipation, and abdominal pain. Central nervous system involvement is not rare and has a wide spectrum of presentation in enteric fever.[ncbi.nlm.nih.gov]
Falling
  • Common symptoms of ataxia include: Clumsy speech pattern ( dysarthria ) Repetitive eye movements ( nystagmus ) Uncoordinated eye movements Walking problems (unsteady gait) that can lead to falls The health care provider will ask if the person has recently[nlm.nih.gov]
  • The symptoms include staggering, falling, a drunken and uncertain gait; gross intention tremor, staccato speech and nystagmus are frequently present. There are no abnormal findings in the cerebrospinal fluid and fever is absent.[pediatrics.aappublications.org]
  • Below are some important signs and symptoms: Patient resists walking or falls frequently while trying to walk or stand. The gait is unsteady and the child is unable to walk in a straight line. Bends or sways sideways while walking.[tandurust.com]
  • Acquired ataxia Acquired ataxia can have a wide range of potential causes, including: severe head injury – after a car crash or fall , for example bacterial brain infection, such as meningitis or encephalitis (an infection of the brain itself) viral infection[nhs.uk]
Difficulty Walking
  • walking Speech disturbances with slurred speech and changes in tone, pitch, and volume Visual complaints Abnormal eye movements Headache Nausea and vomiting Lightheadedness Changes in mental state, such as personality or behavioral changes Chaotic eye[cookchildrens.org]
  • Symptoms associated with acute cerebellar ataxia include: Coordination impairment in arms, legs and torso Unsteady gait Difficulty walking, frequent stumbling Nystagmus (repetitive eye movements, uncontrolled) Difficulty with fine motor tasks Impaired[topclassactions.com]
Hypoxemia
  • However, hypoxemia intractable to steroid pulse therapy developed and the patient died of respiratory failure. The autopsy revealed diffuse alveolar hemorrhage with no finding of vasculitis.[ncbi.nlm.nih.gov]
Intravenous Administration
  • The distribution of rCBF was measured by SPECT imaging after intravenous administration of 123I-IMP (111 MBq).[ncbi.nlm.nih.gov]
Overeating
  • We applied the technique of electrical stimulation over the cerebellum which was reported previously (Ugawa et al., J Physiol 441 (1991a) 57).[ncbi.nlm.nih.gov]
Cerebellar Ataxia
  • Acute cerebellar ataxia is usually a self-limited benign disease, which may develop in children after certain viral infections or vaccinations. There are several reports of acute cerebellar ataxia associated with autoantibodies.[ncbi.nlm.nih.gov]
  • Most common virus causing acute cerebellar ataxia are Chickenpox virus and Epstein Barr Virus. It is a diagnosis of exclusion. Acute cerebellar ataxia usually follows 2–3 weeks after an infection. Onset is abrupt.[en.wikipedia.org]
Nystagmus
  • A 54-year-old woman with adenocarcinoma of the lung and lymph node metastasis experienced nystagmus and cerebellar ataxia 2 weeks after initiating nivolumab therapy.[ncbi.nlm.nih.gov]
  • Horizontal nystagmus is present is approximately 50% of cases.[en.wikipedia.org]
Tremor
  • Abstract Acute Cerebellar Ataxia (ACA) is not infrequent disorder in childhood characterized by sudden onset of such cerebellar signs as truncal ataxia, dysmetria, tremors, nystagmus, and hypotonicity.[ncbi.nlm.nih.gov]
  • Action tremors (also known as intention tremors) are shaking movements that become worse when performing voluntary movements. In acute cerebellar ataxia, the signs discussed above are not caused by weakness or a loss of the sense of balance.[medfriendly.com]
  • Register TREMORINE-TREMOR, SHIVERING AND ACUTE CEREBELLAR ATAXIA IN THE ADULT AND CHILD—A COMPARATIVE STUDY - 24 Hours access EUR 36.00 GBP 28.00 USD 45.00 Rental This article is also available for rental through DeepDyve.[academic.oup.com]
  • Hand and leg tremors while walking or writing. Irregular and rapid jerking of the eyes when the patient attempts to fix his vision on some object.[tandurust.com]
  • The symptoms include staggering, falling, a drunken and uncertain gait; gross intention tremor, staccato speech and nystagmus are frequently present. There are no abnormal findings in the cerebrospinal fluid and fever is absent.[pediatrics.aappublications.org]
Cerebellar Sign
  • Abstract Acute Cerebellar Ataxia (ACA) is not infrequent disorder in childhood characterized by sudden onset of such cerebellar signs as truncal ataxia, dysmetria, tremors, nystagmus, and hypotonicity.[ncbi.nlm.nih.gov]
  • Neurologic examination revealed cerebellar signs without signs of meningitis or cranial nerve involvement. CT and MRI were normal and CSF showed a mild pleocytosis and normal protein and glucose.[pediatricneurologybriefs.com]
  • The child is otherwise well but suddenly develops cerebellar signs, including imbalance and gait abnormalities. Other common symptoms may include the following: horizontal nystagmus, truncal and/or head titubation, dysarthria, and dysmetria.[clinicaladvisor.com]
  • Examination is unremarkable, with no clear cerebellar signs other than ataxia. Initial episodes warrant an MRI.[healio.com]
Cerebellar Disease
  • Paraneoplastic cerebellar degeneration: This is cerebellar disease occurring with cancer, but not due to brain secondaries; it may be related to antibodies.[patient.info]
  • Here we set out to briefly describe the clinical/anatomical correlates of cerebellar disease and to provide a broad differential diagnosis for patients who present with cerebellar ataxia.[els.net]
  • disease Hereditary cerebellar syndrome in specified disease NEC G32.81 ICD-10-CM Codes Adjacent To G32.81 G31.83 Dementia with Lewy bodies G31.84 Mild cognitive impairment, so stated G31.85 Corticobasal degeneration G31.89 Other specified degenerative[icd10data.com]

Workup

  • […] been reported in rare cases. 2 APCA essentially is a diagnosis of exclusion; thus, other causes of acute cerebellar ataxia such as intoxications, paraneoplastic syndromes, trauma, and migraine must be excluded during the course of a thorough diagnostic workup[consultant360.com]
  • Therefore, further workup is often necessary. A urine and/or serum toxicology screen is ordered to rule out ingestion/intoxication. A complete blood count (CBC) is ordered to evaluate for changes supportive of illness.[clinicaladvisor.com]
Positive Widal Test
  • The diagnosis of enteric fever was confirmed by positive blood culture, strongly positive Widal test and rising antibody titres. The major clinical features were rapid development of gait ataxia, limb ataxia and dysarthria.[ncbi.nlm.nih.gov]
Legionella Pneumophila
  • Acute-phase and convalescent-phase sera of 66 children, aged 3 months to 12 years, with neurologic disorders of unknown etiology were tested against Legionella pneumophila polyvalent and monovalent antigens (groups 1 to 4).[ncbi.nlm.nih.gov]

Treatment

  • Cerebellar ataxia caused by a recent viral infection may not need treatment. People whose condition was caused by a recent viral infection should make a full recovery without treatment in a few months.[nlm.nih.gov]
  • Following treatment with appropriate antibiotics, the patient showed complete recovery over the next four weeks.[ncbi.nlm.nih.gov]
  • However, treatment is necessary if the underlying cause is not virus disease. Treatment will depend on the cause. Antibiotic drugs are mainstay treatment for cerebellar ataxia caused due to bacterial infection.[tandurust.com]

Prognosis

  • Patients with Sjögren's syndrome have higher risk for lymphoma, which leads to poorer prognosis. After lymph node biopsy, the patient was proven to have sinus histiocytosis, which is another rare finding in Sjögren's syndrome.[ncbi.nlm.nih.gov]

Etiology

  • A case of acute cerebellar ataxia with discrete signs of pyramidal and tegmental involvement is reported, several days after recovery from an upper respiratory infection of unknown etiology.[ncbi.nlm.nih.gov]

Pathophysiology

  • Although an autoimmune process may contribute to the mechanism of ACA, its pathophysiology is not completely understood. We report a girl with recurrent ACA and anti-cardiolipin antibodies.[ncbi.nlm.nih.gov]
  • […] generally is preceded by a prodromal viral infection, approximately 10 to 15 days before onset. 1,2 Boys are more prone to developing ACA after infections, and they tend to have worse gait dysfunction and cranial nerve palsies, along with nystagmus. 2 The pathophysiology[consultant360.com]
  • Most cases follow severe injuries; 20 however, a few children have been noted to have cerebellar concussion following relatively minor head trauma. 21 The pathophysiology is believed to be damage to the connections between the cerebellum and the cortex[healio.com]

Prevention

  • Prevention There are no current guidelines to prevent acute cerebellar ataxia. You can make sure that your child's vaccinations are up to date. This can prevent infections that increase their risk of getting this condition.[winchesterhospital.org]
  • Hospital for Sick Children Health A-Z Search a complete list of child health articles expand_more View All Drug A-Z Search a list of articles about medications expand_more View All Learning Hubs Browse a complete list of content groups Healthy Living & Prevention[aboutkidshealth.ca]
  • Reducing your risk of stroke by exercising, maintaining a healthy weight, and keeping blood pressure and cholesterol in check can also be helpful in preventing ACA.[healthline.com]
  • There is no effective way to prevent cerebellar ataxia. The only means that may reduce the occurrence of the disease is proper vaccination against certain viruses that may be associated with acute cerebellar ataxia.[ic.steadyhealth.com]

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