Abstract
Background Acute cerebellar ataxia is a clinical syndrome which involves loss of balance and coordination, normally within less then 72 hours. Post infectious acute cerebellar syndrome usually presents in children, but it rarely affects adults as well.
Case Study A 21-year-old backpacker presented with acute onset dizziness, vertigo, truncal ataxia, and dysarthria two weeks following an acute viral illness. MRI Brain identified evidence of dural enhancement. Lumbar puncture established a normal cerebrospinal fluid protein and glucose, with 7 white cells. Subsequent investigations revealed evidence of a recent viral infection. Following treatment with intravenous methyl prednisolone, her symptoms resolved gradually over months.
Literature Review Reveals multiple case reports in children and adolescence but rarely in adults. Patient often presents with gait disturbance, nystagmus, dysarthria, headache, nausea, and vomiting. MRI findings may include inflammation and T2 hyperintensity in the basal ganglia, brainstem, and cerebellar region, together with obstructive hydrocephalus. Typical CSF findings include normal or mildly elevated leucocytes with normal proteins and glucose. While the prognosis is normally good, steroid therapy and intravenous immunoglobulin has been shown to assist in hastening recovery in protracted cases.
Conclusion While post infectious acute cerebellar syndrome is rare in adults, it is an important cause of an acute presentation of ataxia that should be considered by neurologists, and which typically results in complete recovery.
