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Acute Cerebellar Ataxia

(Cerebellitis)

Definition

Acute cerebellar ataxia is a sudden problem with coordination and balance. It happens when the cerebellum is damaged. This is the part of the brain that controls these functions.

Cerebellum
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Causes

In some people, the cause is not known. It others, it may be due to genetics or:

  • Infections
  • Problems with the immune system
  • Head injury

Risk Factors

This problem is more common in young children. Other things that may raise the risk are:

  • Viral infections, such as chickenpox, Coxsackie virus, Epstein-Barr, or HIV
  • Bacterial infections, such as Lyme disease
  • Exposure to certain toxins, such as lead, mercury, thallium, alcohol, and some insecticides
  • A history of chemotherapy
  • Bleeding, abscess, blood clots, or blockage in the cerebellum
  • Paraneoplastic syndromes—happens when the immune system attacks the cerebellum in the area of a cancer
  • Certain vaccinations

Recurrent acute cerebellar ataxia may be marked by periods of inactivity and flares. Things that may raise the risk of this are:

Symptoms

Problems may be:

  • Coordination problems when using the arms, legs, or trunk
  • Problems walking
  • Clumsiness
  • Headache
  • Lightheadedness
  • Speech problems, such as slurred speech and changes in tone, pitch, and volume
  • Problems swallowing
  • Nausea and vomiting
  • Eyesight problems, including eyes that do not move in the usual way
  • Changes in mental state, such as personality or behavioral changes

Diagnosis

The doctor will ask about your symptoms and health history. A physical exam will be done. A neurological exam may also be done.

Blood tests may be done. The fluid around the brain and spinal cord may also be tested. This can be done with a lumbar puncture.

Images may be taken. This can be done with:

Nerve function may be tested. This can be done with a nerve conduction study.

The electrical activity of the muscles may be tested. This can be done with an electromyography (EMG).

Treatment

Ataxia in children may go away on its own in a few months. In others, underlying causes of ataxia will need to be treated. This may include medicine to ease swelling in the brain.

Therapy may be also needed. Options are:

  • Physical therapy to help with movement
  • Occupational therapy to help with everyday tasks and self-care
  • Speech therapy to improve swallowing and speaking

Prevention

There are no current guidelines to prevent this health problem.

RESOURCES

National Ataxia Foundation
http://www.ataxia.org

National Institutes of Neurological Disorders and Stroke
http://www.ninds.nih.gov

CANADIAN RESOURCES:

Canadian Institutes of Health Research
http://www.cihr-irsc.gc.ca

Health Canada
https://www.canada.ca

REFERENCES:

Cerebellar ataxia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cerebellar-ataxia. Accessed January 22, 2021.

Cerebellar disorders. Patient website. Available at: https://patient.info/doctor/cerebellar-disorders. Accessed January 22, 2021.

Encephalopathy information page. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/Disorders/All-Disorders/Encephalopathy-Information-Page. Accessed January 22, 2021.

van Gaalen J, van de Warrenburg BP. A practical approach to late-onset cerebellar ataxia: putting the disorder with lack of order into order. Pract Neurol. 2012 Feb;12(1):14-24.

Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD  Last Updated: 1/22/2021