Background: Previous reports on the relative frequency of different causes of acute ataxia in children found post-infectious ataxia as the most common diagnosis, accounting for about 30-50% of cases, and varicella as the most common associated virus.
Aim: To identify the most common causes of acute ataxia in children in the era of post-varicella vaccination, and the diagnostic yield of common diagnostic work-up.
Methods: This retrospective study reviewed medical records of children, presented with ataxia of less than 72 hours` duration, over the last 12 years. Associated signs and symptoms, laboratory, EEG and neuroimaging studies, final diagnosis and clinical findings at discharge and during follow up were studied.
Results: Total of 58 patients (35 boys and 23 girls), mean age 4.9±3.8 years were enrolled. The most common etiology of acute ataxia in our study remain post infectious acute cerebellar ataxia (50%), these children were significantly younger (3.6±3.1 vs.6.2±4.1 years, p=0.01) and 86% were younger than 5 years. In those children extra cerebellar neurological signs were absent. The abnormality yield of work-up studies performed in our cohort was 45% for lumbar puncture, 36% for EEG, 10% for CT scan and 34% for MRI.
Conclusions: Post infectious acute cerebellar ataxia remains the most common cause of acute ataxia in children. Although lumbar puncture and neuroimaging should be considered in all children with acute ataxia, younger children with history of previous viral illness and absent extra cerebellar neurological signs may benefit from watchful waiting.
