Acute Cerebellar Ataxia: Causes, Symptoms, and Diagnosis

 

What is acute cerebellar ataxia?

Acute cerebellar ataxia (ACA) is a disorder that occurs when the cerebellum becomes inflamed or damaged. The cerebellum is the area of the brain responsible for controlling gait and muscle coordination.

The term ataxia refers to a lack of fine control of voluntary movements. Acute means the ataxia comes on quickly, on the order of minutes to a day or two. ACA is also known as cerebellitis.

People with ACA often have a loss of coordination and may have difficulty performing daily tasks. The condition most commonly affects children, particularly those between ages 2 and 7. However, it occasionally affects adults as well.

What causes acute cerebellar ataxia?

Viruses and other diseases that affect the nervous system can injure the cerebellum. These include:

• chickenpox
• measles
• mumps
• hepatitis A
• infections caused by the Epstein-Barr and Coxsackie viruses
• West Nile virus

ACA can take weeks to appear following a viral infection.

Other causes of ACA include:

• bleeding in the cerebellum
• exposure to mercury, lead, and other toxins
• bacterial infections, such as Lyme disease
• head trauma
• deficiencies of certain vitamins, such as B-12, B-1 (thiamine), and E

What are the symptoms of acute cerebellar ataxia?

The symptoms of ACA include:

• impaired coordination in the torso or arms and legs
• frequent stumbling
• an unsteady gait
• uncontrolled or repetitive eye movements
• trouble eating and performing other fine motor tasks
• slurred speech
• vocal changes
• headaches
• dizziness

These symptoms are also associated with several other conditions that affect the nervous system. It’s important to see your doctor so they can make a proper diagnosis.

How is acute cerebellar ataxia diagnosed?

Your doctor will run several tests to determine whether you have ACA and to find the underlying cause of the disorder. These tests can include a routine physical exam and various neurological assessments. Your doctor may also test your:

• hearing
• memory
• balance and walking
• vision
• concentration
• reflexes
• coordination

If you weren’t infected with a virus recently, your doctor will also look for signs of other conditions and disorders that commonly lead to ACA.

There are a number of tests your doctor can use to evaluate your symptoms, including:

• Nerve conduction study. A nerve conduction study determines whether your nerves are working correctly.
• Electromyography (EMG). An electromyogram records and evaluates the electrical activity in your muscles.
• Spinal tap. A spinal tap allows your doctor to examine your cerebrospinal fluid (CSF), which surrounds the spinal cord and brain.
• Complete blood count (CBC). A complete blood count determines whether there are any decreases or increases in your number of blood cells. This can help your doctor assess your overall health.
• CT or MRI scan. Your doctor may also look for brain damage using these imaging tests. They provide detailed pictures of your brain, allowing your doctor to get a closer look and evaluate any damage in the brain more easily.
• Urinalysis and ultrasound. These are other tests that your doctor might perform.

How is acute cerebellar ataxia treated?

Treatment for ACA isn’t always necessary. When a virus causes ACA, a full recovery is usually expected without treatment. Viral ACA generally goes away in a few weeks without treatment.

However, treatment is usually required if a virus is not the cause of your ACA. The specific treatment will vary depending on the cause, and can last weeks, years, or even a lifetime. Here are some possible treatments:

• You may need surgery if your condition is the result of bleeding in the cerebellum.
• You may need antibiotics if you have an infection.
• Blood thinners can help if a stroke caused your ACA.
• You can take medications to treat inflammation of the cerebellum, such as steroids.
• If a toxin is the source of ACA, reduce or eliminate your exposure to the toxin.
• If ACA was brought on by a vitamin deficiency, you can supplement high doses of vitamin E, injections of vitamin B-12, or thiamine.