science

Post-viral cerebellar ataxia

Post-viral cerebellar ataxia is a science topic covered in the lgStudy science library. This page brings together a partial reference excerpt, illustrations, worked examples, real-world applications and a short study plan, so you can understand Post-viral cerebellar ataxia rather than just read about it. In short: Post-viral cerebellar ataxia also known as acute cerebellitis and acute cerebellar ataxia (ACA) is a disease characterized by the sudden onset of ataxia following a viral infection. The disease affects the function or structure of the cerebellum region in the brain.

Key takeaways

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Reference excerpt

Post-viral cerebellar ataxia also known as acute cerebellitis and acute cerebellar ataxia (ACA) is a disease characterized by the sudden onset of ataxia following a viral infection. The disease affects the function or structure of the cerebellum region in the brain.

Symptoms and signs Most symptoms of people with post-viral cerebellar ataxia deal to a large extent with the movement of the body. Some common symptoms that are seen are clumsy body movements and eye movements, difficulty walking, nausea, vomiting, and headaches.

Causes Post-viral cerebellar ataxia is caused by damage to or problems with the cerebellum. It is most common in children, especially those younger than age 3, and usually occurs several weeks following a viral infection. Viral infections that may cause it include chickenpox, Coxsackie disease (also called hand-foot-and-mouth disease), Epstein–Barr virus (a common human virus that belongs to the herpes family), influenza, HIV, and SARS-CoV-2 (the virus that causes COVID-19).

Diagnosis Since the majority of ACA cases result from a post-viral infection, the physician's first question will be to ask if the patient has been recently ill. From this point a series of exclusion tests can determine if the current state of ataxia is a correct diagnosis or not. A CT (computed tomography) scan with normal results can rule out the possibility of the presence of a posterior fossa tumor and an acute hemorrhage, which would both have abnormal results. Other imaging tests like EEG (electroencephalographs) and MRI (magnetic resonance imaging) can also be performed to eliminate possible diagnoses of other severe diseases, such as neuroblastoma, drug intoxication, acute labyrinthitis, and metabolic diseases. A more complicated test that is performed for research analysis of the disease is to isolate viruses from the CSF (cerebrospinal fluid). This can show that the virus has attacked the nervous system of the patient and resulted in the ataxia symptoms.

Differential diagnosis Differential diagnosis may include:

Opsoclonus-myoclonus-ataxia syndrome Miller-Fisher syndrome Meningoencephalitis Cerebral abscess Tumor Hydrocephalus Inner-ear disease Acute vestibulitis Acute labyrinthitis Pneumonia

Treatment Ataxia usually goes away without any treatment. In cases where an underlying cause is identified, medical treatment may be needed. In extremely rare cases, patients can have continuing and disabling symptoms. Treatment includes corticosteroids, intravenous immunoglobulin, or plasma exchange therapy. Drug treatment to improve muscle coordination has a low success rate. However, the following drugs may be prescribed: clonazepam, amantadine, gabapentin, or buspirone. Occupational or physical therapy may also alleviate lack of coordination. Changes to diet and nutritional supplements may also help. Treatment will depend on the cause. If the ataxia is due to bleeding, surgery may be needed. For a stroke, medication to thin the blood can be given. Infections may need to be treated with antibiotics. Steroids may be needed for swelling (inflammation) of the cerebellum (such as from multiple sclerosis). Cerebellar ataxia caused by a recent viral infection may not need treatment.

Prognosis People whose condition was caused by a recent viral infection should make a full recovery without treatment in a few months. Fine motor skills, such as handwriting, typically have to be practised in order to restore them to their former ability. In more serious cases, strokes, bleeding or infections may sometimes cause permanent symptoms. Be aware that in some cases, recovery may take years and affect the central nervous system in many undescribed ways.

History Westphal reported the first documented case of post-viral cerebellar ataxia in 1872, where associations of reversible cerebellar syndrome were observed. Another early case was documented in 1905. Batten described in detail cases of post-infectious cerebellar ataxia in five children. The cause of the disease was unknown until 1978 when Weiss and Guberman proposed that ACA could be due to direct invasion of the central nervous system by infectious agents. Since then many case studies have followed to understand the underlying conditions, symptoms and causes of the disease. The largest study of retrospective childhood ACA was done in 1994 by Connolly. This disease is still commonly used as a reference in clinical practice for other inflammatory and autoimmune disorders of the nervous system.

See also Acute cerebellar ataxia of childhood

References

Further reading http://health.nytimes.com/health/guides/disease/acute-cerebellar-ataxia/overview.html https://web.archive.org/web/20111021044049/http://www.bettermedicine.com/article/cerebellar-ataxia-syndrome/symptoms%7B%7Bfull%7Cdate%3DAugust 2015 MedlinePlus Encyclopedia: Acute cerebellar ataxia

Illustrations

Worked examples

Example 1 — a first encounter with Post-viral cerebellar ataxia

Start with the simplest possible case. Write down what Post-viral cerebellar ataxia claims or describes in one sentence, then invent the smallest concrete situation in which that sentence is true. In science, the smallest case is usually a single object, a single equation or a single measurement. Check that every symbol or term in your sentence has a meaning in that case.

Example 2 — changing one variable

Take the situation from Example 1 and change exactly one quantity: double it, halve it, or set it to zero. Predict what should happen to Post-viral cerebellar ataxia before you calculate. Comparing your prediction with the result is the fastest way to find out whether you understand the idea or only the words.

Example 3 — an exam-style question

Typical questions about Post-viral cerebellar ataxia ask you to (a) state it precisely, (b) apply it to given data, and (c) explain a limitation. Practise writing all three answers in under five minutes; the third part is what separates a full-mark answer from an average one.

Applications of Post-viral cerebellar ataxia

In research: Post-viral cerebellar ataxia appears in science research whenever the underlying quantities have to be modelled precisely. Papers usually cite it as a starting assumption and then explore where it breaks down.
In technology and industry: Engineering practice reuses Post-viral cerebellar ataxia in design rules, simulations and safety margins. Knowing the idea lets you read a specification sheet and understand why the numbers look the way they do.
In the classroom: Post-viral cerebellar ataxia is common in secondary-school and first-year university syllabi. It links to neighbouring topics Symptoms and signs: Nervous system, so understanding it makes those chapters shorter.
In everyday life: Look for Post-viral cerebellar ataxia outside the textbook — in sport, cooking, traffic, electronics or the sky above you. An example you found yourself is remembered far longer than one you were given.

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Frequently asked questions

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Because it connects several science ideas at once: it gives you a definition you can apply, a quantity you can calculate, and a way to check whether a result is plausible.

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Read the excerpt, restate it from memory, then work through the examples and applications listed on this page. The five-step study plan above takes about twenty minutes.

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