What is acute post-infectious cerebellar ataxia?
Ataxia is a movement disorder, which is a condition where body movements are difficult to control or occur involuntarily. These disorders occur when areas of the brain that are used for movement, coordination, sensation and speech are inflamed or damaged. Some causes of ataxia in children include: infection, head injury, medications, and toxins such as illicit substances, lead poisoning and carbon monoxide.
Acute post-infectious cerebellar ataxia is the most common form of acute ataxia found in children and occurs after some types of infections.
The following definitions can be helpful in understanding the term acute post-infectious cerebellar ataxia:
- Acute — all signs and symptoms appear within a short period of time, in this case within two days.
- Post-infectious — occurring after an infection.
- Cerebellar — coming from the cerebellum. The cerebellum is a part of the brain important in controlling movement.
It is most commonly seen between the ages of two and six, but can also occur in older children.
Signs and symptoms of ataxia
A child with ataxia has difficulty controlling or coordinating their movements and may appear clumsy or awkward. They may have some of the following symptoms:
What causes acute post-infectious cerebellar ataxia?
When a child has an infection, the immune system helps the body fight the infection by destroying viruses and bacteria. Sometimes the immune system can also cause inflammation in the cerebellum. When the cerebellum is inflamed, its regular function is affected.
The typical timeline of acute post-infectious cerebellar ataxia is as follows:
- A child will get an infection, usually with a fever.
- The infection and fever get better.
- A few days to three weeks later ataxia starts to develop. Difficulty with walking is the most common symptom.
- Ataxia develops quickly, usually over the course of one to two days.
Acute post-infectious cerebellar ataxia can occur after many types of infections. It has been linked to varicella (chicken pox), but it can also develop after other viral infections, some types of pneumonia, and Lyme disease.
Some viruses that can cause post-infectious cerebellar ataxia are prevented with routine vaccinations. Therefore, keeping vaccines up to date can help to prevent this condition.
How is acute post-infectious cerebellar ataxia diagnosed?
There is no specific test for acute post-infectious cerebellar ataxia. Instead, it is diagnosed by a process of elimination, where more serious types of ataxia are first excluded.
Your child’s history, or the description of recent events leading up to the ataxia, will help their health-care team make this diagnosis. They will be looking for a recent infection, as well as acute onset of your child’s ataxia. The health-care team may also ask about other signs or symptoms, such as persistent fever, seizures or neck pain, which could point to a different cause of the ataxia.
Your child will be examined. The health-care team will look for the signs and symptoms of ataxia. They will also look for symptoms that could suggest a different diagnosis.
Often, tests may be performed to help diagnose the cause of ataxia. These can include blood work or imaging the brain using a CT scan or MRI.
Treatment of acute post-infections cerebellar ataxia
Post-infectious cerebellar ataxia usually goes away on its own and does not require treatment.
However, your child may be sent home from the hospital while still experiencing symptoms of ataxia. In this case, special precautions must be taken to keep your child safe until their symptoms disappear.
Taking care of your child at home
Your child may be sent home before their ataxia has gone away. Your child may have difficulty walking and may fall easily. It is very important to make sure the home environment is safe for your child during this time. You may need to have an adult supervise your child at all times throughout the day.
It is important that you are comfortable taking your child home before they can walk or move normally. Please talk to your child’s health-care team if you are worried about keeping your child safe at home.
Will my child go back to normal? When?
In the majority of cases, acute post-infectious cerebellar ataxia goes away completely in two to three weeks. Most children have no lasting problems with walking or with other movements.
When to see a health-care provider
Make an appointment with your child’s health-care provider if:
- your child’s ataxia is not improving after two weeks
- your child’s ataxia returns after it has gone away
- your child develops a fever
Go to your nearest Emergency Department or call 911 if:
- your child becomes confused or disoriented
- your child becomes unresponsive, or very sleepy and difficult to wake up
- your child has new abnormal movements that could be seizures
- your child develops severe neck pain and a fever
- your child develops a severe headache