Author: Alison L. Christy, MD, PhD    
Providence Pediatric Neurology at St. Vincent Medical Center—Portland, Oregon 

Reviewed: August 2022

SUMMARY

Acute cerebellar ataxia (ACA) is a specific type of cerebellar ataxia that occurs in children. It usually occurs after a viral infection. ACA causes a sudden loss of balance and coordination. Symptoms typically resolve within two to four weeks.

Disorder Overview

DESCRIPTION

ACA is most commonly seen in children under the age of six. However, older children and teenagers can also be affected. Often, children are sick with a fever before symptoms start.  

Symptoms are acute. This means they develop quickly, in hours or days.  

The cerebellum controls balance and stability of movements. When the cerebellum is not working correctly, patients experience: 

• Vertigo (the sensation that the room is spinning)  
• Ataxia (loss of coordination)  

ACA usually goes away over time, without any treatment. 

SIGNS AND SYMPTOMS

Ataxia means “loss of coordination.” Some symptoms associated with a sudden loss of coordination include: 

• Loss of balance  
• Clumsiness 
• Unsteady walking, with feet kept far apart  
• Wobbling when sitting 
• Unusual, jerking eye movements  
• Nausea or vomiting  
• Slurred speech  
• Irritability  

CAUSES

In most cases, ACA occurs after an infection with a fever. It is thought to be post-infectious or autoimmune. Post-infectious means it is caused by the infection itself. Autoimmune means it is caused by immune cells attacking parts of the body instead of fighting off bacteria. We do not know why some children develop ACA after an infection.  

Chicken pox (varicella infection) was once the most common cause of ACA. This has decreased with vaccination. Many other viruses can cause ACA as well. ACA has been reported with COVID-19 infection, although this is rare. 

LABORATORY INVESTIGATIONS

ACA is a clinical diagnosis. It is made after a careful history and exam. However, sometimes tests can be used to rule out other causes of ataxia.  

Other tests may include:

TREATMENT

There is no treatment for acute cerebellar ataxia. Symptoms should resolve over time. However, medications may be used to help a patient feel better. These include medications for:  

• Nausea 
• Vertigo 
• Headaches

OUTLOOK

ACA almost always goes away around two weeks after onset, without any lingering symptoms. However, symptoms can sometimes last for months. Older children may be more likely to have symptoms for a longer period of time.

RELATED DISORDERS

• Acute disseminated encephalomyelitis (ADEM) 
• Autoimmune encephalitis 
• Cerebellar ataxia 
• Stroke 
• Meningitis/encephalitis 

Child Neurology Foundation (CNF) solicits resources from the community to be included on this webpage through an application process. CNF reserves the right to remove entities at any time if information is deemed inappropriate or inconsistent with the mission, vision, and values of CNF. 

Research 

Currently, there are no listings for Acute Cerebellar Ataxia in ClinicalTrials.gov. Check back often and talk with your healthcare provider to identify upcoming trials.   

If you have an interest in searching for any future trials that may be starting:  

1. Go to the Home page of ClinicalTrials.gov  
2. Under “Status”, click on “Recruiting and not yet recruiting studies”  
3. Under “Condition or disease”, type Acute Cerebellar Ataxia in the field. A drop-down list will appear if this disorder is included.  
4. You can narrow the search by entering a Country name  
5. Once on the disorder page of trials, narrow your search under “Eligibility Criteria” and click “Age/Age Group/Child (birth to 17)”  

 ClinicalTrials.gov is a database of privately and publicly funded clinical studies conducted around the world. This is a resource provided by the U.S. National Library of Medicine (NLM), which is an institute within the National Institutes of Health (NIH). Listing a study does not mean it has been evaluated by the U.S. Federal Government. Please read the NLM disclaimer for details.     

Before participating in a study, you are encouraged to talk to your health care provider and learn about the risks and potential benefits.    

The information in the CNF Child Neurology Disorder Directory is not intended to provide diagnosis, treatment, or medical advice and should not be considered a substitute for advice from a healthcare professional. Content provided is for informational purposes only.  CNF is not responsible for actions taken based on the information included on this webpage. Please consult with a physician or other healthcare professional regarding any medical or health related diagnosis or treatment options. 

Caffarelli M, Kimia AA, Torres AR. Acute Ataxia in Children: A Review of the Differential Diagnosis and Evaluation in the Emergency Department. Pediatr Neurol. 2016 Dec;65:14-30. https://doi.org/10.1016/j.pediatrneurol.2016.08.025. Epub 2016 Sep 8. PMID: 27789117. 

Cook Children’s. Acute Cerebellar Ataxia [Internet]. Cook Children’s Health Care System. Available from: https://www.cookchildrens.org/services/neurosciences/conditions/acute-cerebellar-ataxia/ 

Desai J, Mitchell WG. Acute cerebellar ataxia, acute cerebellitis, and opsoclonus-myoclonus syndrome. J Child Neurol. 2012 Nov;27(11):1482-8. https://doi.org/10.1177/0883073812450318. Epub 2012 Jul 17. PMID: 22805251. 

Gilbert D. Acute cerebellar ataxia in children [Internet]. UpToDate. 2022. Available from: https://www.uptodate.com/contents/acute-cerebellar-ataxia-in-children  

Gieron-Korthals MA, Westberry KR, Emmanuel PJ. Acute childhood ataxia: 10-year experience. J Child Neurol. 1994 Oct;9(4):381-4. https://doi.org/10.1177/088307389400900408. PMID: 7822728. 

Ryan MM, Engle EC. Acute ataxia in childhood. J Child Neurol. 2003 May;18(5):309-16. https://doi.org/10.1177/08830738030180050901. PMID: 12822814. 

Thakkar K, Maricich SM, Alper G. Acute Ataxia in Childhood: 11-Year Experience at a Major Pediatric Neurology Referral Center. J Child Neurol. 2016 Aug;31(9):1156-60. https://doi.org/10.1177/0883073816643407. Epub 2016 Apr 12. PMID: 27071467.