Acute Cerebellar Ataxia
(Cerebellitis)
Definition
Acute cerebellar ataxia is a disorder of the nervous system marked by the sudden onset of a disturbance in muscle coordination, especially in the trunk, arms, and legs.
The cerebellum is the part of the brain that controls balance and coordination. It does not function properly in the case of cerebellar ataxia. Although the abnormality of the limbs is most often noticed, it can also cause abnormal eye movements. Nausea and vomiting may also occur as part of the disorder.
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.
If you suspect you or your child has this condition, call the doctor right away.
Cerebellum (Darker Pink Section)

Causes
Causes of acute cerebellar ataxia include:
-
Viral infections, including:
- Chickenpox
- Coxsackie disease
- Epstein-Barr virus
- Mycoplasma pneumonia
- HIV infection
- Lyme disease
- Exposure to insecticides called organophosphates
- Exposure to certain toxins, such as lead , mercury , thallium, and alcohol
- Cerebellar hemorrhage, abscess, blood clot, or obstruction of an artery
Causes of recurrent or chronic acute ataxia include:
- Stroke
- Malformation of the cerebellum
- Multiple sclerosis
- Migraine or vertigo
- Genetic or metabolic disorders
- Brain tumor
- Alcoholism
- Seizures
Plaque Build-up From Multiple Sclerosis

Risk Factors
These factors increase your chance of developing acute cerebellar ataxia. Tell your doctor if you have any of these risk factors:
- Childhood, especially three years of age or younger
- Viral infections
- Recent vaccination
- Exposure to certain insecticides, drugs, or toxins
Symptoms
If you experience any of the following symptoms, do not assume it is due to acute cerebellar ataxia. These symptoms may be caused by other conditions, as well. If you experience any one of them, see your doctor:
- Uncoordinated movements of the limbs or trunk
- Clumsiness with daily activities
- Difficulty walking (unsteadiness)
- Speech disturbances with slurred speech and changes in tone, pitch, and volume
- Visual complaints
- Abnormal eye movements
-
Accompanying symptoms may include:
- Headache
- 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, medical and family history, and perform a physical exam. He will observe your limb coordination to assess the degree and nature of the ataxia.
Further tests may include the following:
- Examination of cerebrospinal fluid
- MRI scan —a test that uses magnetic waves to make pictures of structures inside the head
- CT scan —a type of x-ray that uses a computer to make pictures of structures inside the head
- Metabolic blood tests
- Ultrasound—a test that uses sound waves to examine the head
- Urine analysis
-
Tests to detect other possible diseases that are causing the symptoms:
- Nerve conduction study —a test that measures the speed and degree of electrical activity in a nerve to determine if it is functioning normally
- Electromyography (EMG)—a test measures and records the electrical activity that muscles generate at rest and in response to muscle contraction
Treatment
There is no treatment for acute cerebellar ataxia. Ataxia usually goes away without any treatment within a few months. In cases where an underlying cause is identified, your doctor will treat the that cause.
In extremely rare cases, you may have continuing and disabling symptoms. Treatment includes:
- Corticosteroids
- Intravenous immune globulin
- Plasma exchange therapy
Drug treatment to improve muscle coordination has a low success rate. However, the following drugs may be prescribed:
- Clonazepam (eg, Klonopin)
- Amantadine (eg, Symmetrel)
- Gabapentin (eg, Neurontin)
- Buspirone (eg, BuSpar)
Occupational or physical therapy may also alleviate lack of coordination. Changes to diet and nutritional supplements may also help.
Resources:
National Ataxia Foundation
http://www.ataxia.org/index.aspx/
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
http://www.hc-sc.gc.ca/index-eng.php/
References:
Berman P. Ataxia in children.
International Pediatrics.
1999:14:44-47.
Bradley WG, Daroff RB. Neurology in Clinical Practice. Philadelphia, PA: Butterworth Heinemann Publishing; 2004.
Cerebellar ataxia. BBC News website. Available at: http://news.bbc.co.uk/1/hi/health/medical_notes/4055425.stm . Accessed November 26, 2006.
Cerebellar ataxia. Patient UK website. Available at: http://www.patient.co.uk/showdoc/40001724/ . Accessed November 26, 2006.
Cerebellar ataxia: a guide for the medical profession. Ataxia UK website. Available at: http://www.ataxia.org.uk/publications_and_pictures/ca_guide_for_medical_professionals.pdf . Accessed November 27, 2006.
Cerabellar disorders. The Merck Manuals Online Medical Library website. Available at: http://www.merck.com/mmpe/sec16/ch221/ch221j.html?qt=cerebellar%20ataxia&alt=sh . Accessed November 27, 2006.
Encephalopathy. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/encephalopathy/encephalopathy.htm . Accessed November 26, 2006.
Mack KJ, Lehwald L. Acute cerebellar ataxia in children. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. MedLink website. Available at: http://www.medlink.com . Accessed February 18, 2009.
Muthugovindan D. Acute cerebellar ataxia in children. In: Gilman S, ed. MedLink Neurology. San Diego, CA: MedLink Corporation. MedLink website. Available at: http://www.medlink.com . Accessed February 4, 2009.
Ropper AH, Brown RH. Adams and Victor's Principles of Neurology. 8th ed. New York, NY: McGraw-Hill Medical Publishing Division; 2005: chap 33.
Stumpf DA. Acute ataxia. Pediatr Rev. 1987;8;303-306
Last reviewed January 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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