Identifying the cause of cerebellar ataxia is key to deciding whether or not treatment is necessary.
Acute cerebellar ataxia consists of the sudden appearance of uncoordinated muscular movements resulting from some type of injury to the cerebellum.
The cerebellum is the area of the brain that is responsible for controlling muscle movement, balance, and coordination.
Although this disease can appear at any age, acute cerebellar ataxia is predominant in children around 3 years of age. Most cases are self-limited and do not usually need treatment.
Etiology of acute cerebellar ataxia
Some of the causes that favor the appearance of this disease are the following:
- Presence of abscesses in the brain.
- Use of certain medications. Ataxia is sometimes a side effect of some drugs such as barbiturates or benzodiazepines. This type of ataxia is usually the easiest to manage since when the substance disappears, the situation is reversed.
- Alcohol. Alcohol abuse can alter the absorption of some vitamins and thus precipitate the appearance of acute cerebellar ataxia.
- Exposure to insecticides.
- Brain hemorrhages. One of the most common causes is head trauma and the subsequent bleeding that can lead to it.
- Autoimmune diseases such as multiple sclerosis.
- Cerebrovascular accidents Among them we can highlight the thrombi, which favor the appearance of ischemia by altering the circulatory flow of the cerebellum. Depending on how long the alteration persists, the consequences may or may not be repairable.
- Administration of vaccines.
- Genetic inheritance.
- Brain tumors. The presence of these cell masses can alter the functionality of the cerebellum causing some type of pathology to appear, such as ataxia.
This pathology appears frequently in children in the weeks after a viral infection.
Among the viruses that are capable of producing acute cerebellar ataxia we have the varicella virus (the most commonly associated), the coxsackie, the Epstein Barr virus or the ECHO virus.
Certain diagnostic methods used to confirm the existence of acute cerebellar ataxia are computerized tomography (CT), magnetic resonance imaging, and spinal tap.
The most common symptoms in acute cerebellar ataxia are the following:
- Dysarthria. It consists of the appearance of difficulties in articulating words, which leads to a very choppy way of speaking.
- Nystagmus or rapid and uncoordinated eye movements.
- Unstable gait and difficulty walking.
- Nausea and vomiting
- Symptoms of depression and anxiety.
This type of ataxia in turn affects body movements from the neck to the hip, but also those related to the extremities.
The prognosis of the disease usually depends on the cause. In this way, if it is a viral infection, it will be convenient for the patient to recover completely without the need for treatment.
However, if the cause is related to cerebrovascular accidents or cerebellar hemorrhages, the disease may be irreversible.
Acute cerebellar ataxia tends to disappear over time. There is no specific treatment, as it usually disappears by itself within a few months of its onset. If any treatment is prescribed, it will usually depend on the underlying cause:
- Surgery and anticoagulants are often used when ataxia has appeared as a result of hemorrhage or stroke.
- Antibiotics if ataxia is concomitant with a bacterial infection.
- Corticosteroids to reduce inflammation of the cerebellum.
To try to improve coordination, some benzodiazepines are indicated, such as clonazepam; amantadine, gabapentin or buspirone, which are anxiolytic.
Likewise, another factor that may be interesting to include in treatment is rehabilitation. This, along with physical therapy and occupational therapy, can help to regain posture and some movements.