Download ENGLISH 3050 PROJECT 1 Post Viral Cerebellar

ENGLISH 3050
PROJECT 1
Post Viral Cerebellar Ataxia
By Emma, Whitney, Aminur, Ali and Milad
Post viral cerebellar ataxia
Post viral cerebellar ataxia (ACA) also known, as Acute Cerebellitis is a disease
characterized by the sudden onset of ataxia following a viral infection. [1]. The
disease affects the function or structure of the cerebellum region in the brain.
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 test 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 other severe diseases like Neuroblastoma, drug intoxication,
acute labyinthitis, and metabolic diseases from the possible diagnoses. 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:
Opoclonus-myoclonus-ataxia syndrome,
Miller-Fisher syndrome,
Meningoencephalitis
Cerebral abscess
Tumor Hydrocephalus
Inner-ear Disease
Acute Vestibulitis
Acute Labyrinthitis
Symptoms
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. Most symptoms of people with Post Viral Cerebellar Ataxia deal to a
large extent with the movement of the body. The balance and coordination of the
human body is controlled by the part of the brain called the cerebellum.
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 Post
Viral Cerebellar Ataxia include the following; Chickenpox, Coxsackie Disease (viral
infection also called hand-foot-and-mouth disease), Creutzfeldt-Jakob Disease (a
rare disease believed to be an infection that causes mental deterioration), Lyme
Disease (inflammatory bacterial disease spread by ticks), Mycoplasma Pneumonia
(type of bacterial pneumonia), Epstein-Barr Virus (a common human virus that
belongs to the herpes family) and HIV.
Treatment
Ataxia usually goes away without any treatment. In cases where an underlying
cause is identified, your doctor will treat the underlying cause. In extremely rare
cases, you may 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 acute cerebellar 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.
Outlook (Prognosis)
People whose condition was caused by a recent viral infection should make a full
recovery without treatment in a few months. Strokes, bleeding, or infections may
cause permanent symptoms.
History:
Westphal reported the first documented case of Post viral cerebellar ataxia in 1872,
where associations of reversible cerebellar syndrome were observed.[2] Another
early case was documented in 1905 batten described in detail cases of postinfectious 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 infection agents.
Since then many cases 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.[3]
Reference:
[1] Moshe Nussinovitch, Dario Prais, Benjamin Volovitz, Rivka Shapiro, & Jacob Amir.
(2003). Post-infectious acute cerebellar ataxia in children. Clinical Pediatrics, 42(7),
581-4. Retrieved September 21, 2011, from Research Library. (Document ID:
477180951).
[2] Russell C. Dale, Angela Vincent, Inflammatory and Autoimmune Disorders of the
Nervous System, issue 184, p. 190-193
[3] Jong Seok Bae, Byoung Joon Kim, Cerebellar ataxia and acute motor axonal
neuropathy associated with Anti GD1b and Anti GM1 antibodies, Journal of Clinical
Neuroscience, Volume 12, Issue 7, September 2005, Pages 808-810,
[4] Post-infectious acute cerebellar ataxia in children
Moshe Nussinovitch;
Dario Prais; Benjamin Volovitz; Rivka Shapiro; Jacob Amir Clinical Pediatrics; Sep
2003; 42, 7; Research Library pg. 581
[5] http://health.nytimes.com/health/guides/disease/acute-cerebellarataxia/overview.html
[6] http://www.bettermedicine.com/article/cerebellar-ataxiasyndrome/symptoms
[7] http://www.nlm.nih.gov/medlineplus/ency/article/001397.htm
[8]http://www.lifescript.com/Health/A-Z/Conditions_A-Z/Conditions/A/
Acute_cerebellar_ataxia.aspx
[9] http://www.nlm.nih.gov/medlineplus/ency/article/001397.htm