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Acute cerebellar ataxia (ACA), also known as cerebellitis, is a disorder that occurs when the cerebellum becomes inflamed or damaged. The cerebellum is the area of the brain responsible for controlling gait and muscle coordination. People with ACA often have a loss of coordination and may have difficulty performing daily tasks. The condition most commonly affects children, particularly those between ages 2 and 7.
Symptoms of Acute Cerebellar Ataxia
The symptoms of ACA include:
impaired coordination in the torso or arms and legs
an unsteady gait
uncontrolled or repetitive eye movements
trouble eating and performing other fine motor tasks
behavioral or personality changes
These symptoms are also associated with several other conditions that affect the nervous system. It’s important to see your doctor so they can make a proper diagnosis.
Your doctor will run several tests to determine whether you have ACA and to find the underlying cause of the disorder. These tests can include a routine physical exam and various neurological assessments. Your doctor may also test your:
If you weren't infected with a virus recently, your doctor will also look for signs of other conditions and disorders that commonly lead to ACA.
There are a number of tests your doctor can use to evaluate your symptoms, including:
A nerve conduction study determines whether your nerves are working correctly.
Electromyography (EMG) records and evaluates the electrical activity in your muscles.
A spinal tap allows your doctor to examine your cerebrospinal fluid. This is the fluid that surrounds the spinal cord and brain.
A complete blood count (CBC) determines whether there are any decreases or increases in your number of blood cells. This can help your doctor assess your overall health.
Your doctor may also look for brain damage using a CT or MRI scan. These imaging tests provide detailed pictures of your brain, allowing your doctor to get a closer look and evaluate any damage in the brain more easily.
Other tests your doctor might perform include a urinalysis and an ultrasound.
Viruses and other diseases that affect the nervous system can injure the cerebellum. These include chickenpox, and infections caused by the Epstein-Barr and Coxsackie viruses. ACA can take weeks to appear following a viral infection.
Other causes of ACA include:
bleeding in the cerebellum
exposure to mercury, lead, and other toxins
bacterial infections, such as Lyme disease
ACA can develop in anyone, but it typically affects children under age 8.
Treatment for ACA isn’t always necessary. When a virus causes ACA, a full recovery is usually expected without treatment. Viral ACA generally goes away in a few months without treatment.
However, treatment is usually required if a virus is not the cause of your ACA. The specific treatment will vary depending on the cause.
You may need surgery if your condition is the result of bleeding in the cerebellum.
You may need antibiotics if you have an infection.
Blood thinners can help if a stroke caused your ACA.
There are also medications you can take that directly treat inflammation of the cerebellum.
If you have ACA, you might need help with daily tasks. Special eating utensils and adaptive devices such as canes and speaking aids can help. Physical therapy, speech therapy, and occupational therapy may also help improve your symptoms. Some people also find that making certain lifestyle changes, such as changing their diet and taking nutritional supplements, can further relieve the symptoms.
The symptoms of ACA might become permanent when the disorder is caused by a stroke, an infection, or bleeding into the cerebellum. If you have ACA, you’re also at a higher risk for developing anxiety and depression, especially if they you need help with daily tasks or you’re unable to get around on your own. Joining a support group or meeting with a counselor can help you cope with your symptoms and any challenges you’re facing.
It's difficult to prevent ACA, but you can reduce your children’s risk of getting it. Make sure they get vaccinated against the viruses that can lead to ACA, such as chickenpox.
Although ataxia is generally not curable, a great deal can be done to ease symptoms and improve the quality of life of the patient. Treatment for coordination and balance problems usually involves the use of adaptive devices that help the patient attain as much independence as possible. These may include the use of a cane (walking stick), crutches, walker, or a wheelchair.
Symptoms such as tremor, stiffness, spasticity, sleep disorders, muscle weakness, depression (or frustration, sadness, and anger) may be addressed with targeted physical therapy, speech therapy, medications, and counseling.
Occupational therapy: This can help the person manage better around the house and at work. It may involve some home adaptations, wheelchair assessment, and making the kitchen more practical.
Speech therapy: This can help with swallowing, coughing, choking, and speech problems. If speech becomes very difficult, the speech therapist can help the person learn how to use speech aids.
Orthopedic care: This can help treat curvature of the spine.
Physical therapy: This can help maintain strength and improve mobility.
Counseling: Sessions can help the person manage frustration and depression that may arise when symptoms affect physical mobility and coordination.
Supplements and nutrition: If levels of vitamin E are low, supplements, a special diet, or both may help. Sensitivity to gluten can occur with ataxia, so a gluten-free diet may help.
Medication: Treatment for ataxia telangiectasia include gamma-globulin injections to boost the immune system. There are also drugs for muscle spasms and uncontrollable eye movements.
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