Cerebellar ataxia due to Leptospirosis- a case report

Abstract

BackgroundLeptospirosis involves nervous system in around 10-15% of the cases, the commonest presentation being aseptic meningitis. Most of the clinical features of neuroleptospirosis are due to capillary endothelial damage and vasculitis. Ataxia is an extremely uncommon manifestation of Leptospirosis occuring in <5% of cases.Case presentationA 28 year old female from North India presented with a short febrile illness followed by an acute onset cerebellar ataxia, anemia, thrombocytopenia and transaminitis. Leptospira serology showed high titres of IgM (ELISA) and MAT (microscopic agglutination test titre >1:800) . She was treated with intravenous ceftriaxone for 14 days following which she showed marked recovery.ConclusionThe clinical features of neuroleptospirosis are varied, most of them resulting from endothelial damage and vasculitis. Immune mediated phenomenon with no structural damage is another possible mechanism leading to cerebellar ataxia. Cerebellar ataxia due to common tropical infections should be ruled out in the appropriate setting, as early institution of treatment can abate neurological morbidity.The case report highlights the importance of identifying a reversible cause of cerebellar ataixa due to a tropical infection, possibly due to a immune mediated phenomenon, and would be of interest to both internists and neurologists.

Liver Transplantation for Acute Liver Failure Attributed to Leptospirosis: A Report of Two Cases

“…Aseptic meningoencephalitis is the most common neurological manifestation [6], but cases of myeloradiculopathy, myelopathy, and Guillain Barre syndrome have also been reported. Cerebellar involvement has also been described and is thought to a ect less than 5% of cases [7]. Neurologic involvement in leptospirosis is due to capillary endothelial damage and vasculitis, and its prognosis is generally good.…”

Лептоспіроз: Аспекти Ураження Нервової Системи

“…Можливим механізмом, що призводить до мозочкової атаксії, є імунний. Клінічні прояви включають горизонтальний ністагм при погляді в бік, атактичну ходьбу, скандовану мову, дисметрію та інтенційний тремор при виконанні координаторних проб, похитування в позі Ромберга, адіадохокінез, гіпотонію м'язів [18].…”

Video Anthology of Movement Disorders Due to Infections in South Asia

“…In this video anthology we cover viral, bacterial and parasitic infections based on whether they are common or emergent in South Asia and their propensity to cause movement disorders. Infections that are rare in the region (eg, Whipple's disease 53 ) or do not often cause movement disorders (eg, leptospirosis 54 ) are not discussed. The included videos of 41 cases show the range and characteristics of movement disorders associated with each of the selected infection.…”