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Approach to the child with acute ataxia

Author
Dewesh Agrawal, MD
Section Editors
Stephen J Teach, MD, MPH
Marc C Patterson, MD, FRACP
Deputy Editor
James F Wiley, II, MD, MPH

INTRODUCTION

This topic will review causes and clinical features of acute ataxia in children. Episodic and chronic conditions associated with ataxia will be discussed briefly. An algorithmic approach to the child with acute ataxia is presented.

BACKGROUND

Ataxia can be defined as a disturbance in the smooth, accurate coordination of movements. It is most commonly manifested as an unsteady gait [1].

Ataxia is usually the result of cerebellar dysfunction. However, disturbances at many levels of the nervous system can also affect coordination [2]. As an example, ataxia that develops as the result of loss of sensory function (such as proprioception) would be described as a sensory ataxia.

Acute ataxia is an uncommon presenting complaint in children. Although causes of acute ataxia include life-threatening conditions such as mass lesions and central nervous system (CNS) infection, the majority of children have a benign, self-limited process. Historical features, specific physical findings, and selected ancillary studies can identify most causes of ataxia, particularly those that are serious and require stabilization and intervention.

CAUSES

Conditions that cause acute ataxia include acute infections, post-infectious inflammatory conditions, toxins, tumors, and trauma (table 1). In one retrospective series, 80 percent of children with acute ataxia who were evaluated in an emergency department and subsequently hospitalized had a discharge diagnosis of acute cerebellar ataxia, a toxic ingestion, or Guillain-Barré syndrome [3].

                             

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Literature review current through: Nov 2016. | This topic last updated: Mon Jul 20 00:00:00 GMT+00:00 2015.
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