Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content +++ Key Features ++ Most common cause of acute childhood ataxia Accounts for about 40% of all cases Occurs most commonly in children aged 2–6 years Symptoms may include refusal to walk due to ataxia, in addition to sudden development of a wide-based, drunken gait Families may not report unsteadiness of arm movements, ataxia of the trunk, or dysarthria, but these symptoms are essential to localization Serious causes include cns infections and intracranial mass lesions +++ Clinical Findings ++ Onset is abrupt Evolution of symptoms is rapid In about 70% of patients, a prodromal illness occurs with fever, respiratory or gastrointestinal symptoms, or an exanthem within 3 weeks of onset. Associated viral infections include varicella, rubeola, mumps, echovirus infections, poliomyelitis, infectious mononucleosis, and influenza. Bacterial infections such as scarlet fever and salmonellosis have also been incriminated. Mental status is normal in these patients, as is sensory and reflex testing. +++ Diagnosis ++ Cerebrospinal fluid opening pressure, protein, and glucose levels are typically normal, though a mild pleocytosis with lymphocytic predominance can be seen Any significant elevation in white blood count and protein level should prompt an evaluation for meningitis or encephalitis CT and MRI scans are typically normal Occasionally focal cerebellar or cerebellopontine demyelinating lesions or enhancement of the meninges can be seen Decreased regional blood flow in the cerebellum on SPECT without abnormal foci on MRI of the brain has also been reported +++ Treatment ++ Supportive Intravenous immunoglobulin (IVIg) has been used Corticosteroid use does not result in any improvement About 80–90% of patients recover without sequelae within 6–8 weeks, though some may demonstrate residual behavioral changes, learning problems, eye movement abnormalities, and speech problems GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. Access My Subscription GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessPediatrics 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessPediatrics Full Site: One-Year Individual Subscription $595 USD Buy Now View All Subscription Options