Ataxia differential diagnosis: Difference between revisions
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|'''Acute cerebellitis''' | |'''Acute cerebellitis''' | ||
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* Primary infectious, postinfectious or postvaccination disorder. | *Primary infectious, postinfectious or postvaccination disorder. | ||
* Epstein-Barr virus, influenza A and B, mumps, varicella-zoster virus, coxsackie virus, rotavirus, echovirus, ''Mycoplasma pneumoniae'' and immunization | *Epstein-Barr virus, influenza A and B, mumps, varicella-zoster virus, coxsackie virus, rotavirus, echovirus, ''Mycoplasma pneumoniae'' and immunization | ||
|From self-limited to fatal, depending on the amount of cerebellar swelling | |From self-limited to fatal, depending on the amount of cerebellar swelling | ||
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*Blood/CSF: Antibodies anti- HSV, EBV, VZV, mumps, rubella, Lyme disease | *Blood/CSF: Antibodies anti- HSV, EBV, VZV, mumps, rubella, Lyme disease | ||
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* Postinfectious cerebellitis typically occurs between one and six weeks after varicella or measles, but also can follow Epstein-Barr or other viral infections and vaccinations in teenagers and young adults. | *Postinfectious cerebellitis typically occurs between one and six weeks after varicella or measles, but also can follow Epstein-Barr or other viral infections and vaccinations in teenagers and young adults. | ||
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* Trunk and limbs ataxia, fever, abnormal eye movements, dysarthria, headache, nausea, vomiting and decreased level of consciousness | *Trunk and limbs ataxia, fever, abnormal eye movements, dysarthria, headache, nausea, vomiting and decreased level of consciousness | ||
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|'''Bacterial infection''' | |'''Bacterial infection''' | ||
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* Mycoplasma pneumoniae, Listeria monocytogenes | *Mycoplasma pneumoniae, Listeria monocytogenes | ||
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* Lumbar puncture for examination of the cerebrospinal fluid (CSF) and microbiologic testing | *Lumbar puncture for examination of the cerebrospinal fluid (CSF) and microbiologic testing | ||
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* Fever | *Fever | ||
* instability when walking | *instability when walking | ||
* changes in coordination that primarily affect the trunk or head and not the limbs | *changes in coordination that primarily affect the trunk or head and not the limbs | ||
* nodding or other unusual head movements | *nodding or other unusual head movements | ||
* unusual eye movements, such as involuntarily darting from side to side | *unusual eye movements, such as involuntarily darting from side to side | ||
* slow or slurred speech | *slow or slurred speech | ||
* changes in mood, behavior, or personality | *changes in mood, behavior, or personality | ||
* headaches | *headaches | ||
* nausea or vomiting | *nausea or vomiting | ||
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|'''Acquired immunodeficiency syndromes''' | |'''Acquired immunodeficiency syndromes''' | ||
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|'''Toxic ingestions''' | |'''Toxic ingestions''' | ||
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* Alcohol, benzodiazepines, or other anticonvulsant drugs or exposure to environmental toxins such as mercury or lead | *Alcohol, benzodiazepines, or other anticonvulsant drugs or exposure to environmental toxins such as mercury or lead | ||
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* Toxicology testing | *Toxicology testing | ||
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* Additional findings that suggest occult ingestion (eg, depressed consciousness) | *Additional findings that suggest occult ingestion (eg, depressed consciousness) | ||
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|'''Atypical infections''' | |'''Atypical infections''' | ||
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* Progressive multifocal leukoencephalopathy | *Progressive multifocal leukoencephalopathy | ||
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* Progressive and multifocal | *Progressive and multifocal | ||
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* Magnetic resonance imaging (MRI) reveals a multifocal process limited to the white matter | |||
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* Caused by reactivation of the JC virus in immunocompromised hosts. | *Caused by reactivation of the JC virus in immunocompromised hosts. | ||
|Presents with subacute neurologic deficits like altered mental status, motor deficits (hemiparesis or monoparesis), limb ataxia, gait ataxia, and visual symptoms such as hemianopia and diplopia | |Presents with subacute neurologic deficits like altered mental status, motor deficits (hemiparesis or monoparesis), limb ataxia, gait ataxia, and visual symptoms such as hemianopia and diplopia | ||
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|'''Brain tumors''' | |'''Brain tumors''' | ||
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* Nonmalignant and malignant tumors of the brain and spinal cord. | *Nonmalignant and malignant tumors of the brain and spinal cord. | ||
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* Symptoms and signs of tumor local invasion, | *Symptoms and signs of tumor local invasion, | ||
* Adjacent structures compression, | *Adjacent structures compression, | ||
* Raised intracranial pressure | *Raised intracranial pressure | ||
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|'''Stroke''' | |'''Stroke''' |
Revision as of 16:19, 24 August 2020
TYPE | CAUSE | PROGRESSION | IMAGING FEATURES and OTHER TESTS | ASSOCIATED FACTORS | SYMPTOMS |
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Acute cerebellitis |
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From self-limited to fatal, depending on the amount of cerebellar swelling |
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Bacterial infection |
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Acquired immunodeficiency syndromes |
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Chronic alcohol use/Alcoholic cerebellar degeneration |
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Rapid progression (weeks or months) |
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Antibiotic-induced acute ataxia |
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Weeks after initiation |
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Toxic ingestions |
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Atypical infections |
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Presents with subacute neurologic deficits like altered mental status, motor deficits (hemiparesis or monoparesis), limb ataxia, gait ataxia, and visual symptoms such as hemianopia and diplopia |
Brain tumors |
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Stroke | |||||
Vestibular neuritis |