Ataxia

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 of it 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—this happens when the immune system attacks the cerebellum near a cancer
• Some vaccinations

A person may have acute cerebellar ataxia that goes away and comes back. Things that may raise the risk of this are:

• Stroke
• A cerebellum that is not formed well
• Problems with the immune system, such as multiple sclerosis
• Migraine
• Vertigo
• Genetic or metabolic disorders
• A brain tumor
• Alcohol use disorder
• Some medicines

Symptoms

A person with acute cerebellar ataxia may have:

• Problems walking, clumsiness, or coordination problems when using the arms, legs, or trunk
• 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 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:

• MRI scan
• CT scan
• Ultrasound

The nerves may be checked to see how well they are working. 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

The goals of treatment are to: 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 daily tasks and self-care
• Speech therapy to help with swallowing and speaking

Prevention

There are no guidelines to prevent this health problem.

References

• Cerebellar ataxia. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cerebellar-ataxia.
• Encephalopathy. National Institute of Neurological Disorders and Stroke website. Available at: https://www.ninds.nih.gov/health-information/disorders/encephalopathy.
• Pedroso, J.L., Vale, T.C., et al. Acute cerebellar ataxia: differential diagnosis and clinical approach. Arq Neuropsiquiatr, 2019; 77 (3): 184-193.