Differential Diagnosis for Acute Cerebellar Ataxia
Single Most Likely Diagnosis
- Posterior Fossa Stroke: This is often the most common and critical diagnosis to consider in acute cerebellar ataxia due to the potential for rapid deterioration and need for urgent intervention. The cerebellum's role in coordination and balance makes a stroke in this area a likely cause of acute ataxia.
Other Likely Diagnoses
- Viral Cerebellitis: Infections can cause inflammation of the cerebellum, leading to ataxia. This condition is more common in children but can occur in adults.
- Toxic or Metabolic Causes: Certain toxins (e.g., alcohol, certain medications) and metabolic disorders can cause cerebellar dysfunction leading to ataxia.
- Multiple Sclerosis: Although more commonly associated with optic neuritis and spinal cord lesions, multiple sclerosis can present with cerebellar symptoms, including ataxia.
Do Not Miss Diagnoses
- Brain Tumor: Although less common, a tumor in the posterior fossa can cause ataxia and has significant implications for treatment and prognosis.
- Subarachnoid Hemorrhage: Bleeding into the space surrounding the brain can lead to increased intracranial pressure and cerebellar dysfunction, presenting as ataxia among other symptoms.
- Wernicke's Encephalopathy: Caused by thiamine deficiency, often seen in alcoholics, this condition requires immediate treatment to prevent irreversible damage.
Rare Diagnoses
- Paraneoplastic Cerebellar Degeneration: A rare condition associated with certain cancers, where the immune system mistakenly attacks the cerebellum.
- Creutzfeldt-Jakob Disease: A prion disease that can cause rapid neurological deterioration, including ataxia, though it is exceedingly rare.
- Ataxia Telangiectasia: A genetic disorder that affects the nervous system, immune system, and other bodily systems, characterized by ataxia and telangiectasias, typically presenting in childhood.