Non-progressive cerebellar ataxia and previous undetermined acute cerebellar injury: a mysterious clinical condition

Acute Cerebellar Ataxia: An Unusual Pediatric Case

BACKGROUND

Acute cerebellar ataxia is a clinical syndrome with sudden onset of uncoordinated gait and normal mental status in young children. Although it has a benign clinical course, it often requires an exhaustive diagnostic work-up in order to rule out potentially life-threatening etiologies that present similarly. The wide differential encompasses causes from infections, brain masses, drugs, toxins, trauma, paraneoplastic syndromes, as well as hereditary or congenital disorders.

CASE REPORT

We report on a 4-year-old boy with recent hand-foot-mouth disease who presented with acute cerebellar ataxia. In addition to his marked truncal ataxia and wide-based, staggering gait, he had slowness of speech, which is not commonly reported with this condition in the literature. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians have a unique role in being first to evaluate pediatric ataxia and can make a significant impact on identifying potentially fatal mimickers of acute cerebellar ataxia. This article will attempt to outline major diagnostic considerations in order to aid emergency physicians through their clinical approach.