The cerebellum is an important part of brain which controls voluntary movement such as walking, writing, staying balanced and upright. Infection, inflammation or any type of damage to the cerebellum can affect your gait and muscle coordination. The condition is referred as cerebellar ataxia. Acute cerebellar ataxia (ACA) mainly occurs in children under the age of 7, although older children or adolescents can also suffer from this condition.
Acute cerebellar ataxia usually develops after infection, mainly viral infection such as chickenpox, measles, etc. Brain trauma, lead poisoning etc are other causes. Fortunately, in majority of patients the unsteady gait, irritability, slurred speech usually disappear after few weeks or months without any specific treatment, if the underlying cause is post virus infection. However, medications are necessary if the cause is bacterial infection or brain trauma.
Causes Of Acute Cerebellar Ataxia
Acute cerebellar ataxia occurs when the signals that are transmitted to and fro from the cerebellum are disrupted. Since cerebellum is responsible for movement, balance and muscle coordination, disruption of signals can alter its functions. Damage to the cerebellum either due to infection or inflammation can lead to acute cerebellar ataxia. It usually occurs after an acute fever caused due to viral infection.
The disease is commonly encountered in children below the age of 7 after an attack of viral infection such as chickenpox, measles, mumps, etc. Acute cerebellar ataxia can also develop in adults after infection with Epstein-Barr virus or mycoplasma pneumoniea organisms, typhoid fever, herpes virus etc.
Acute cerebellar ataxia can also occur due to brain trauma, bleeding from the blood vessels supplying cerebellum, lead, mercury and pesticide poisoning, alcohol intoxication or bacterial infections that may cause cerebellar abscess or encephalitis.
Symptoms Of Acute Cerebellar Ataxia
The syndrome is commonest in children who have started walking, between 1 and 7 years. Adults too can be affected in rare instances. There may be history of fever or just simple cold before the symptoms. Sometimes there is no history of previous illness. The onset is sudden.
Principal feature is unsteady gait that has evolved within few hours to one to two days. The child refuses to walk and becomes clumsy. Below are some important signs and symptoms:
- Patient resists walking or falls frequently while trying to walk or stand.
- The gait is unsteady and the child is unable to walk in a straight line.
- Bends or sways sideways while walking.
- Wide gait meaning the patient walks keeping his feet quiet apart in order to maintain balance.
- Slurred and clumsy speech as there is lack of coordination of muscles of face.
- Difficulty in swallowing as the muscle of throat is affected.
- Hand and leg tremors while walking or writing.
- Irregular and rapid jerking of the eyes when the patient attempts to fix his vision on some object.
Acute Cerebellar Ataxia Diagnosis
Since there are many other conditions that can cause altered movement and muscle in-coordination, the doctor will take a detailed history; examine the patient thoroughly to determine if it is acute cerebellar ataxia.
He will also recommend certain tests for neurological assessment. These tests are CT brain scan, blood tests, X-ray of skull, electromyelogram, for evaluating the condition.
Treatment Options For Acute Cerebellar Ataxia
Acute cerebellar ataxia is self limited disease that may cure on its own if the underlying cause is post virus infection. Most cases of ACA are viral in origin. The symptoms last for few weeks or months and resolve completely without any residual disability.
However, treatment is necessary if the underlying cause is not virus disease. Treatment will depend on the cause. Antibiotic drugs are mainstay treatment for cerebellar ataxia caused due to bacterial infection.
Surgery may be necessary if there is a large blood clot due to bleeding from the vessels from traumatic brain injury. Blood thinners are useful when ACA results from stroke.
The symptoms of ACA become permanent if it is caused due to stroke, brain injury, or bacterial infection. In such situation auxilary treatment is essential to improve speech, muscle movement, coordination. Hence depending on the severity, patient is advised to follow speech therapy, occupational therapy. Some patients may also need counseling as they become depressed since they find difficulty in doing their daily chores.
Homeopathic medicines have played significant role in achieving good control over swallowing difficulty, uncontrolled eye movement, tremors etc in acute cerebellar ataxia. There are several medicines, but commonly used are gelsemium, agaricus, belladonna, causticum, conium etc.