Cerebellar examination

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Causes of cerebellar ataxia

Causes of acute ataxia:

  • Drug/toxin (alcohol, phenytoin, piperazine neuroleptics, pesticides)
  • Head injury
  • Infection (coxsackie, echo, influenza)
  • Lesion (infarct, tumour, abscess, bleed)
  • Cerebral tumours e.g. brainstem, hydrocephalus, Arnold Chiari malformation
  • Hypoglycemia
  • Labyrinthitis
  • Vitamin E and zinc deficiency

Causes of episodic ataxia:

  • Basillar artery migraine
  • Seizures
  • Metabolic - MSUD; porphyria; Hartnup disease; urea cycle disorders

Causes of chronic ataxia:

  • Ataxic cerebral palsy (10% of all cerebral palsy)
  • Degnerative - Friedreich ataxia, AT, Wilson, Refsum, Batten, metachromatic leukodystrophy
  • Neoplastic - astrocytoma, medulloblast (opsiclonus myoclonus), haemangioblastoma of cerebellum
  • Other: hypothyroid, multiple sclerosis (rare in childhood), abetalipoproteinaemia
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