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Acute cerebellar ataxia

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

 

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

Causes

 

Acute cerebellar ataxia in children, particularly 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, medicines, 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)

 

Exams and Tests

 

The health care provider 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:

  • CT scan of the head
  • MRI scan of the head
  • Spinal tap

 

Treatment

 

Treatment depends on the cause:

  • If the acute cerebellar ataxia is due to bleeding, surgery may be needed.
  • For a stroke, medicine 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.

 

Outlook (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.

 

Possible Complications

 

In rare cases, movement or behavioral disorders may persist.

 

When to Contact a Medical Professional

 

Call your provider if any symptoms of ataxia appear.

 

 

References

Mink JW. Movement disorders. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 597.

Subramony SH, Xia G. Disorders of the cerebellum, including the degenerative ataxias. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 97.

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            Review Date: 2/23/2017

            Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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