Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Resident : Mirhadi Razavian
Gender : Female
Age : 36
A 36 y/o female with ataxia and vertigo
CT demonstrates some hypodensity areas in both cerebellar hemispheres especially in left sided. MRI demonstrates some hyperintensity areas in all sequenses(T1,T2,FLAIR,GRADIENT) in both cerebellar hemispheres especially in left sided
Differential diagnosis may include:
• Opoclonus-myoclonus-ataxia syndrome
• Miller-Fisher syndrome
• Cerebral abscess
• Inner-ear Disease
• Acute Vestibulitis
• Acute Labyrinthitis
Discussion (Related Text)
Post-viral cerebellar ataxia (ACA) also known as acute cerebellitis is a disease characterized by the sudden onset of ataxia following a viral infection. The disease affects the function or structure of the cerebellum region in the brain.
Most symptoms of people with post-viral cerebellar ataxia deal to a large extent with the movement of the body. Some common symptoms that are seen are clumsy body movements and eye movements, difficulty walking, nausea, vomiting, and headaches.
Post-viral cerebellar ataxia is caused by damage to or problems with the cerebellum. It is most common in children, especially those younger than age 3, and usually occurs several weeks following a viral infection. Viral infections that may cause it include the following: chickenpox, Coxsackie disease (viral infection also called hand-foot-and-mouth disease), Creutzfeldt-Jakob disease (a rare disease believed to be an infection that causes mental deterioration), Lyme disease (inflammatory bacterial disease spread by ticks), mycoplasma pneumonia (type of bacterial pneumonia), Epstein-Barr Virus (a common human virus that belongs to the herpes family) and HIV.
Since the majority of ACA cases result from a post-viral infection, the physician’s first question will be to ask if the patient has been recently ill. From this point a series of exclusion tests can determine if the current state of ataxia is a correct diagnosis or not. A CT (computed tomography) scan with normal results can rule out the possibility of the presence of a posterior fossa tumor and an acute hemorrhage, which would both have abnormal results. Other imaging tests like EEG (electroencephalographs) and MRI (magnetic resonance imaging) can also be performed to eliminate possible diagnoses of other severe diseases, such as neuroblastoma, drug intoxication, acute labyrinthitis, and metabolic diseases. A more complicated test that is performed for research analysis of the disease is to isolate viruses from the CSF.
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2. Jump up ^ Jennifer Bergquist, M.D. (2005). "Childhood Ataxia". University of Chicago. Retrieved 7 September 2012.
3. Jump up ^ Russell C. Dale, Angela Vincent, Inflammatory and Autoimmune Disorders of the Nervous System, issue 184, p. 190-193
4. Jump up ^ Jong Seok Bae, Byoung Joon Kim, Cerebellar ataxia and acute motor axonal neuropathy associated with Anti GD1b and Anti GM1 antibodies, Journal of Clinical Neuroscience, Volume 12, Issue 7, September 2005, Pages 808-810
• Post-infectious acute cerebellar ataxia in children Moshe Nussinovitch; Dario Prais; Benjamin Volovitz; Rivka Shapiro; Jacob Amir Clinical Pediatrics; Sep 2003; 42, 7; Research Library pg. 581