Evaluation of the Child With Acute Ataxia: A Systematic Review

Whelan, Harry T.; Verma, Sumit; Guo, Yan; Thabet, Farouq I.; Bozarth, Xiuhua; Nwosu, Michelle E.; Katyayan, Akshat; Parachuri, Venu; Spangler, Katie; Ruggeri, Barbara; Srivatsal, Sindhu; Zhang, Guojun; Ashwal, Stephen

doi:10.1016/j.pediatrneurol.2012.12.005

Cited by 29 publications

(18 citation statements)

References 61 publications

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“…2,6 In many cases, acute ataxia is the first presenting symptom. 7 Our patient presented with many of these symptoms.…”

Section: Discussionmentioning

confidence: 71%

A Toddler With Uncontrollable Shaking After a Minor Fall

Mody²

2017

Pediatr Emer Care

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A toddler with a closed head injury six days prior to admission, recently diagnosed with post-concussive syndrome and acute otitis media presented to our emergency department with complaint of uncontrollable shaking of the head and extremities. Physical examination demonstrated dancing movements of the eyes and truncal ataxia, concerning for the diagnosis of opsoclonus-myoclonus syndrome. Magnetic resonance imaging study was consistent with a retroperitoneal mass that was confirmed as neuroblastoma by metaiodobenzylguanidine scan and later surgical resection. We present this case, accompanied by a video of the patient, to help the emergency physician recognize this rare and often misdiagnosed syndrome.

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“…2,6 In many cases, acute ataxia is the first presenting symptom. 7 Our patient presented with many of these symptoms.…”

Section: Discussionmentioning

confidence: 71%

A Toddler With Uncontrollable Shaking After a Minor Fall

Mody²

2017

Pediatr Emer Care

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“…Opsoclonus-myoclonus syndrome is a rare autoimmune condition mostly associated with neuroblastoma in childhood [15]. Thorax and abdomen CT or MRI or I123 metaiodobenzilguanidin (MIBG) scanning might be helpful for diagnosis of neuroblastoma in these patients because the levels of cathecolamines in the urine are increased in only 47-60% of the cases [16,17,18]. The treatment of acute cerebellar ataxia is usually watchful waiting; physiotherapy may be helpful in selected cases [15].…”

Section: Discussionmentioning

confidence: 99%

Postinfectious Acute Cerebellar Ataxia in Childhood

Ünver¹

2016

Ann Clin Anal Med

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ÖzetAmaç: Postenfeksiyöz akut serebellar ataksi çocukluk çağı ataksilerinin en sık sebebidir. Olgular çocuk acil servis veya çocuk nöroloji polikliniklerine ani başlangıçlı ataksi ile başvururlar. Varisella virüsü en sık ilişkilendiren virüs-tür. Bu çalışmanın amacı postenfeksiyöz akut serebellar ataksi nedeniyle izlenen çocuklarda klinik özellikleri, etiyoloji ve prognozu belirlemek ve çocukluk çağında akut ataksiye genel bir yaklaşım önermektir. Gereç ve Yöntem: Ocak 2011-Haziran 2015 tarihleri arasında başvurmuş 16 çocuğun dosyaları geriye dönük olarak incelendi. Bulgular: Dokuz olgu erkekti (%56,2). Olguların ço-ğunluğunun yaşı 2-5 yaş aralığındaydı (%62,5). Olguların %87,5'inde bulguların ortaya çıkmasından önce viral enfeksiyon öyküsü mevcuttu: Çocukların ikisinde suçiçeği enfeksiyonu, birinde Epstein Barr enfeksiyonu geri kalanlarda nonspesifik ateşli hastalık saptandı. Ateşli hastalık ve bulguların ortaya çıkışı arasındaki ortalama süre 7,4 (±5) gündü. Ortalama hastane yatış süresi 4,37 (± 1,4) gündü. Ortanca iyileşme süresi 7 gündü. En uzun iyileşme süresi 4 aydı. Tartışma: Çocukluk çağında postenfeksiyöz akut serebellar ataksi, ani başla-yan aylar içinde iyileşme gösteren benign bir durumdur. Ancak akut serebellar ataksinin bir dışlama tanısı olduğu unutulmamalı; bu çocuklarda laboratuar testleri ve görüntüleme incelemelerinin uygun kullanımı ile santral sinir sistemi enfeksiyonu ve kitle lezyonu gibi daha ciddi medikal durumların ayı-rıcı tanısı mutlaka yapılmalıdır. Anahtar KelimelerPostenfeksiyöz Akut Serebellar Ataksi; Çocuk; Serebellit; Varisella Enfeksiyonu; Serebellar Ataksi Abstract Aim: Postinfectious acute cerebellar ataxia is the most common cause of childhood ataxia. Cases present with acute onset of ataxia to pediatric emergency and pediatric neurology clinics. Varicella zoster is the most commonly associated virus. The aim of this study is to assess the clinical features, etiology, and prognosis of children with postinfectious acute cerebellar ataxia and to propose a diagnostic approach to acute cerebellar ataxia in children. Material and Method: Files of 16 children admitted between January 2011 and June 2015 were retrospectively evaluated. Results: Nine patients were male (56.2%). The majority of the cases were in the 2-5 years age group (62.5%). A history of a preceding febrile infection was noted in 87.5% of the cases: Two children had varicella infection, one Epstein Barr infection, and the rest nonspecific febrile illness. The mean time interval between the prodromal febrile illness and the onset of the symptoms was 7.4 (±5) days. The mean time of hospitalization was 4.37 (± 1.4) days. The median time for recovery was 7 days. The longest time for recovery was 4 months. Discussion: Postinfectious acute cerebellar ataxia in childhood is the most common cause of childhood ataxia, which presents abruptly and requires recovery over weeks. However, it should be kept in mind that it is a diagnosis of exclusion. Appropriate utilization of laboratory tests and imaging studies is necessary fo...

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“…The most common causes are post-infectious acute cerebellar ataxia, toxin ingestion and Guillain-Barré syndrome. [3] However, the possibility of a mass lesion must always be excluded.…”

Section: Discussionmentioning

confidence: 99%