Differential Diagnosis for Acute Ataxia in Children
Single Most Likely Diagnosis
- Acute Cerebellitis: This condition is often post-infectious and presents with sudden onset of ataxia, which can be accompanied by other symptoms such as headache, fever, and vomiting. It is a common cause of acute ataxia in children and should be considered first due to its relatively high incidence and the potential for significant morbidity if not promptly addressed.
Other Likely Diagnoses
- Cerebellar Stroke: Although less common in children than in adults, cerebellar stroke can cause acute ataxia. The presentation may include sudden onset of ataxia, dysartharia, and nystopia, with or without other focal neurological deficits.
- Posterior Cerebellar Artery Infarction: Similar to cerebellar stroke, this condition can present with acute ataxia and is due to the occlusion of the posterior inferior cerebellar artery or its branches.
- Viral Infections (e.g., Varicella, Coxsackie): Certain viral infections can lead to cerebellar inflammation or direct infection, resulting in acute ataxia. These are often accompanied by other systemic symptoms of infection.
- Toxins and Medications: Exposure to certain toxins (e.g., carbon monoxide, heavy metals) or medications (e.g., phenytoin, carbamazepine) can cause ataxia in children. The history of exposure is crucial for diagnosis.
Do Not Miss Diagnoses
- Cerebellar Tumor or Cyst: Although less common, tumors or cysts in the cerebellum can cause acute ataxia, especially if there is a sudden increase in intracranial pressure or if the tumor bleeds. Prompt diagnosis is critical for treatment and prognosis.
- Intracranial Hemorrhage: Bleeding within the brain can cause sudden onset of ataxia, among other symptoms. It is a medical emergency that requires immediate attention.
- Meningitis or Encephoringitis: Infectious inflammation of the meninges or brain can present with ataxia, along with fever, headache, and altered mental status. Early diagnosis and treatment are crucial to prevent long-term sequelae.
- Vitamin Deficiencies (e.g., Vitamin B12, Vitamin E): Deficiencies in certain vitamins can lead to neurological symptoms, including ataxia. These are important to identify as they are treatable.
Rare Diagnoses
- Ataxia-Telangiectomyasia: A rare genetic disorder characterized by progressive ataxia, telangi descripters, and other systemic features. It typically presents in early childhood.
- Friedreich’s Ataxia: An autosomal recessive genetic disorder that causes progressive damage to the nervous system and presents with ataxia, among other symptoms.
- Mitochondrial Disorders: Certain mitochondrial diseases can present with episodes of acute ataxia, along with other neurological and systemic symptoms.
- Opsinning Myoclonus Syndrome: A rare condition characterized by myoclonus, ataxia, and other neurological symptoms, often associated with a viral infection or vaccination.