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Ataxia, Pediatric

Kristin W. Barañano, MD, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Ataxia refers to incoordination of movement out of proportion to weakness.

  • Can be caused by dysfunction of cerebellum, proprioception, or vestibular system

  • Careful history of timing of...

DIAGNOSIS

HISTORY

  • Focus on the time course of onset.

  • Elicit possible ingestions, access to medications at homes of friends, family

  • Antecedent infections or vaccinations (fever, especially upper respirato...

TREATMENT

  • Treatment of many of the acute ataxias (ingestions, postviral) is supportive.

  • Specific therapies

    • ADEM: corticosteroids

    • GBS: intravenous immunoglobulin (IVIG), plasmapheresis

    • Paraneoplastic: trea...

ONGOING CARE

PROGNOSIS

  • Most acute ataxias are ingestions and postviral and have a good prognosis. If recovery from a presumed postviral ataxia is delayed (>2 weeks), evaluation for neuroblastoma sho...

ADDITIONAL READING

  • Blaser SI, Steinlin M, Al-Maawali A, et al. The pediatric cerebellum in inherited neurodegenerative disorders: a pattern-recognition approach. Neuroimaging Clin N Am.  2016;26(...

CODES

ICD9

  • 781.3 Lack of coordination

  • 334.3 Other cerebellar ataxia

  • 334 Friedreich’s ataxia

  • 334.4 Cerebellar ataxia in diseases classified elsewhere

  • 334.1 Hereditary spastic paraplegia

ICD10

  • R27.0 Ataxia, un...

FAQ

  • Q: Which ingestions are most likely to cause ataxia?

  • A: Alcohol, anticonvulsants, antihistamines, benzodiazepines, TCAs

  • Q: What is the typical time course of postinfectious ataxia?

  • A: Typically, it w...

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