Definition

Acute cerebellar ataxia is a disorder of the nervous system. It is 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.

Causes

Acute cerebellar ataxia may be caused by genetics, viral infections, autoimmune disorders, or injury. In some cases, the cause is unknown.

Risk Factors

Acute cerebellar ataxia is more common in young children, but it can occur at any age. Other factors that may increase your risk of acute cerebellar ataxia include:

• 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 organophosphates found in insecticides
• Cerebellar hemorrhage, abscess, blood clot, or obstruction of an artery
• Paraneoplastic syndromes—occurs when the immune system attacks the cerebellum in the area of a cancer
• Certain vaccinations

Recurrent acute cerebellar ataxia may marked by periods of inactivity and flares. Factors that may increase your chance of recurrent acute cerebellar ataxia include:

• Stroke
• Malformation of the cerebellum
• Autoimmune diseases, including multiple sclerosis
• Migraine or vertigo
• Genetic or metabolic disorders
• Brain tumor
• Alcoholism
• Certain medications

Symptoms

Acute cerebellar ataxia may cause:

• 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
• Headache
• Nausea and vomiting
• Lightheadedness
• Changes in mental state, such as personality or behavioral changes
• Chaotic eye movements
• Difficulty swallowing

Diagnosis

You will be asked about your symptoms, and your medical and family history. A physical exam will be done.

Your bodily fluids may be tested. This can be done with:

• Lumbar puncture
• Blood tests
• Urine tests

Images may be taken of your bodily structures. This can be done with:

• MRI scan
• CT scan
• Ultrasound

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

The electrical activity of your muscles may be tested. This can be done with an 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, the cause will be treated.

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

• Corticosteroids
• IV immune globulin
• Plasma exchange therapy
• Medications to improve muscle coordination

Occupational or physical therapy may also be needed. Changes to diet and nutritional supplements may also help.

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.

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

Health Canada http://www.hc-sc.gc.ca

Cerebellar disorders. Patient UK website. Available at:
http://www.patient.co.uk/doctor/cerebellar-disorders
Updated July 29, 2014. Accessed November 18, 2014.

FAQ. University of Chicago Ataxia Center website. Available at:
http://ataxia.uchicago.edu/page/faq
Accessed November 18, 2014.

Ishikawa N, Kobayashi M. Recurrent acute cerebellar ataxia associated with anti-cardiolipin antibodies. Brain Dev. 2010;32(7):588-591.

Mehta SH, Morgan JC, Sethi KD. Paraneoplastic movement disorders. Curr Neurol Neurosci Rep. 2009;9(4):285-291.

NINDS encephalopathy information page. National Institute of Neurological Disorders and Stroke website. Available at:
http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm
Updated November 9, 2010. Accessed November 18, 2014.

Stumpf DA. Acute ataxia. Pediatr Rev. 1987;8;303-306.