Differential Diagnosis for Ataxia in a 4-year-old

Single Most Likely Diagnosis

• Acute Postinfectious Cerebellitis: This condition is a common cause of ataxia in children, often following a viral infection. It typically presents with sudden onset of ataxia, which can be accompanied by other symptoms such as headache, vomiting, and fever.

Other Likely Diagnoses

• Benign Paroxysmal Vertigo (BPV): A condition characterized by recurrent episodes of vertigo, often triggered by specific head movements. It's a common cause of ataxia in children and usually has a good prognosis.
• Cerebellar Astrocytoma: A type of brain tumor that can cause ataxia, among other symptoms like headache and vomiting. It's more common in children and often has a favorable outcome with treatment.
• Toxins or Medications: Exposure to certain toxins (e.g., lead, mercury) or medications (e.g., anticonvulsants, sedatives) can cause ataxia in children.

Do Not Miss Diagnoses

• Stroke: Although rare in children, a stroke can cause ataxia and is a medical emergency requiring immediate attention.
• Brain Hemorrhage: Similar to stroke, a brain hemorrhage is a critical condition that can present with ataxia and requires urgent medical intervention.
• Infections (e.g., Meningitis, Encephalitis): These conditions can cause ataxia and are medical emergencies due to their potential for severe complications and high mortality if not promptly treated.
• Wernicke's Encephalopathy: Caused by thiamine deficiency, this condition can lead to ataxia and is particularly dangerous if not recognized and treated promptly.

Rare Diagnoses

• Ataxia-Telangiectasia: A rare genetic disorder that affects the nervous system, immune system, and other bodily systems, characterized by ataxia, telangiectasias, and a heightened risk of cancer.
• Friedreich's Ataxia: An autosomal recessive genetic disorder that causes progressive damage to the nervous system, resulting in ataxia, among other symptoms.
• Ataxia with Vitamin E Deficiency (AVED): A rare genetic disorder characterized by ataxia due to a deficiency in vitamin E, which is essential for protecting cells from damage.
• Mitochondrial Disorders: A group of conditions that affect the mitochondria, often presenting with neurological symptoms including ataxia, due to impaired energy production within cells.