Ataxia differential diagnosis

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Acute cerebellitis More common in children and young adults
  • Normal or abnormal brain magnetic resonance imaging (MRI) at onset
  • Epstein-Barr virus, influenza A and B, mumps, varicella-zoster virus, coxsackie virus, rotavirus, echovirus, Mycoplasma pneumoniae and immunization
Bacterial infection
  • Mycoplasma pneumoniae, Listeria monocytogenes
Acquired immunodeficiency syndromes
  • Related to M. pneumonia, Epstein-Barr virus, herpes simplex virus, and toxoplasmosis
Chronic alcohol use/Alcoholic cerebellar degeneration
  • Toxic effects on the central and peripheral nervous systems
  • Direct toxic alcoholic effect on the Purkinje cells
Rapid progression (weeks or months)
  • Vermis atrophy
  • Severe ataxia of gait and lower limbs with relatively mild involvement of the upper limbs.
  • Speech and ocular motility are usually preserved
Antibiotic-induced acute ataxia
  • Interaction of polymyxins with neurons has been associated with the occurrence of several neurotoxic events
Weeks after initiation
  • Brain MRI abnormalities
  • Characteristic reversible MRI signal abnormalities in the cerebellar dentate nuclei, dorsal brainstem, or splenium of the corpus callosum
  • Non-specific EEG abnormalities
  • Ataxia may also occur in isolation or combined with dizziness, generalized muscle weakness, partial deafness, visual disturbances, vertigo, confusion, hallucinations, seizures, and neuromuscular blockade
Para-neoplastic syndrome
Vitamin deficiency
Chronic infections
Neurodegenerative diseases
Brain tumors
Stroke
Vestibular neuritis
Sjögren syndrome

References


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