Acute Ataxia in Childhood

Abstract

Background Acute ataxia is a common reason for presentation to the pediatric emergency department and the pediatric neurology clinic in childhood. Its incidence is between 1/100,000 and 1/500,000. Its most common reason is infections. Objective The aim of this study was to examine the clinical presentation, etiological factors, and prognosis of patients presenting to our regional tertiary pediatric neurology clinic with a diagnosis of acute ataxia. Methods An evaluation was made of patients younger than 18 years diagnosed with acute ataxia in our tertiary pediatric neurology clinic between 2009 and 2016. Results Thirty-nine children were included in the analysis. Sex, age, diagnoses, treatment options, and clinical and radiological findings were evaluated. Acute postinfectious cerebellar ataxia was the most common diagnosis (21/39 [51.2%]). No agent could be identified in viral serological examination in 34 patients (87.2%). Rotavirus was identified in 2 (10.5%) of the acute postinfectious cerebellar ataxia cases, and varicella-zoster virus, herpes simplex virus, and hepatitis A positivities were each identified in 1 case. In 20 (51.2%) of 39 patients, varying treatments were applied according to the primary etiology. Conclusions Acute ataxia is a significant neurological problem in childhood. In this study, Rotavirus was the most common infectious agent. It may be related to vaccination. This study can be considered of value as the most comprehensive study conducted to date on this subject in the eastern region of Turkey.

Early acute cerebellar ataxia after meningococcal B vaccine: a case report of a 7-month-old infant and a review of the literature

“…We searched on PubMed all the literature of the past 30 years published on “Acute Cerebellar Ataxia” and then identified the articles describing pediatric cases of ACA (Table 1 ) with the aim to evaluate the cases that could have relationship with vaccination and the cases with young age at presentation (< 12 months). A total of 20 articles have been evaluated, mostly regarding children and adolescents between 1 and 24 years (mean age 4,2 years, males 54.6%), including 1663 patients [ 5 – 7 , 9 , 14 , 15 , 26 – 39 ]. Three articles declared to include infants, but only one study specified the exact number of patients under 1 year old (3 patients out of 120, 2.5%) [ 7 ].…”

“…2012 [ 31 ] 11 6 (54.5%) 5 (45.5%) 3 to 14 6.7 6.9 No / / / Kirik S. et al . 2021 [ 5 ] 39 21 (53.8%) 18 (46.2%) 1.5 to 16 N.A 6.2 No / / / Kornreich L. et al . 2016 [ 32 ] 9 5 (55.5%) 4 (44.5%) 3 to 13 5.8 6.8 No / / / Lancella L. et al .…”

“…Despite the temporal association with the vaccination, we consider an unknown infective trigger still possible, as it the the most frequently identified cause at our age presentation [ 37 ]. In their study Kirik et al could not identify a certain cause in almost 90% of patients [ 5 ]. According to the WHO criteria [ 42 ], our ACA case can be classified as ‘‘probable’’ to be vaccine-associated.…”

“…Childhood ataxia may be both congenital and acquired, and it is usually associated with CNS congenital anomalies, even if its pathogenesis is not yet fully understood [ 1 ]. Acute cerebellar ataxia (ACA) represents the most common presentation of childhood ataxia with an estimated incidence of 1:100,000–500,000 children per year [ 4 , 5 ].…”

Acute ataxia in paediatric emergency department – diagnostic and therapeutic approach

“…Aciklovir tijekom 3 tjedna indiciran je ako je varicella, tj. VZV/HSV infekcija (ili sumnja na VZV/ HSV infekciju do dolaska nalaza) prethodila razvoju cerebelitisa/ataksije, kortikosteroidi (metilpredniso lon), puls 20 -30 mg/kg i IVIG u slučaju protrahira nog tijeka (npr nakon infekcije EBVom) (5,6).…”