Acute ataxia in childhood – a five year retrospective review<br><b>Abstract in English</b>

Abstract

AIMS: To characterize the cases of acute ataxia hospitalized in a Pediatric Department and to evaluate its approach in the Emergency Department. METHODS: Retrospective analysis of medical records of children admitted between January 2006 and December 2010 with clinical gait and/or fine motor movements with onset within the last 72 hours. RESULTS: We included 82 children, 44 girls. The median age was 4 years. Thirty children had prodromes and 18 had a history of previous infection. The most frequent accompanying symptoms were somnolence (46 cases), vomiting (18 cases) and irritability (14 cases). Physical examination showed no changes in two thirds of cases. Seventy children have been subjected to at least one further diagnostic examination. The main causes were poisoning (53 cases) and post-infectious ataxia (15 cases). Only 16% needed specific treatment and most admissions were of short duration. Thirty-two cases were referred for follow-up consultation. The course was benign in most cases. CONCLUSIONS: The attitude towards a child with acute ataxia should be careful and individualized, making it difficult to implement a uniform protocol for approach. Most cases have a benign and self-limiting course, with short duration admission and only supportive care. However, serious causes must be properly excluded. Detailed clinical history, complete physical and neurological examination, and hospitalization for monitoring of clinical course are crucial.