Acute Cerebellar Ataxia

Definition

Acute cerebellar ataxia is a disorder of the nervous system. It is marked by the sudden onset of a disturbance in coordination. The cerebellum is the part of the brain that plays an important role in balance and coordination. It does not function properly in the case of cerebellar ataxia.

If you suspect you or your child has this condition, call the doctor right away.

Cerebellum (Darker Pink Section)

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Causes

Causes of acute cerebellar ataxia include:

• Viral infections, including:
  • Chickenpox
  • Coxsackie disease
  • Epstein-Barr virus
  • Mycoplasma pneumonia
  • HIV infection
  • Lyme disease
• Exposure to certain toxins, such as lead, mercury, thallium, alcohol, and organophosphates found in insecticides
• Cerebellar hemorrhage, abscess, blood clot, or obstruction of an artery
• Paraneoplastic syndromes—occurs when the immune system attacks the cerebellum

Causes of recurrent or chronic acute ataxia include:

• Stroke
• Malformation of the cerebellum
• Multiple sclerosis
• Migraine or vertigo
• Genetic or metabolic disorders
• Autoimmune diseases, such as anticardiolipin antibody syndrome
• Brain tumor
• Alcoholism
• Seizures

Risk Factors

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 go away without treatment in a matter of months. However, recurrent or chronic progressive cerebellar ataxia does occur.

These factors increase the chances of developing acute cerebellar ataxia:

• Age, especially children three years of age or younger
• Viral infections
• Recent vaccination
• Exposure to certain insecticides, drugs, or toxins

Symptoms

Do not assume the following symptoms are due to acute cerebellar ataxia. These symptoms may be caused by other conditions.

• Uncoordinated movements of the limbs or trunk
• Clumsiness with daily activities
• Difficulty walking
• Speech disturbances with slurred speech and changes in tone, pitch, and volume
• Visual complaints
• Abnormal eye movements
• Accompanying symptoms may include:
  • Headache
  • Nausea and vomiting
  • Dizziness
  • Changes in mental state, such as personality or behavioral changes
  • Chaotic eye movements
  • Clumsy speech pattern

Diagnosis

Your doctor will ask about your symptoms and medical and family history. A physical exam will also be done. Your limb coordination will be observed to assess the degree and nature of the ataxia.

Further tests may include:

• You may need to have your bodily fluids and tissues tested. This can be done with:
  • Lumbar puncture
  • Blood tests
  • Urine analysis
• You may need to have pictures taken of your bodily structures. This can be done with:
  • MRI scan
  • CT scan
  • Ultrasound
• You may need to have your nerve and muscle activity tested. This can be done with:
  • Nerve conduction study
  • Electromyography (EMG)

Treatment

The ataxia that occurs in children can often can go away in a few months without any treatment. In cases where an underlying cause is identified, your doctor will treat the cause.

In some cases, you may have continuing and disabling symptoms. Treatment includes:

• Corticosteroids
• IV immune globulin
• Plasma exchange therapy

Drug treatment to improve muscle coordination has a low success rate. However, the following drugs may be prescribed:

• Clonazepam
• Amantadine
• Gabapentin
• Buspirone

Occupational or physical therapy may also play a role in alleviating lack of coordination. Changes to diet and nutritional supplements may also help.

Prevention

There is no way to prevent acute cerebellar ataxia except to vaccinate children against viral infections that increase their risk of getting this condition.