Ayurvedic management of Cerebellar Ataxia in Children - A Case Report

Rutu  V. Patel

doi:10.21760/jaims.v2i2.7738

Ayurvedic management of Cerebellar Ataxia in Children - A Case Report

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i2.7738 ◽

2017 ◽

Vol 2 (2) ◽

Author(s):

Rutu V. Patel

Keyword(s):

Case Report ◽

Cerebellar Ataxia ◽

Satisfactory Result ◽

Cerebellar Atrophy ◽

Degenerative Changes

Cerebellar ataxia is described as difficulty in maintaining balance and coordinated movements. Cerebellar atrophy is degenerative changes of cerebellum represents as ataxia. Ataxia talangiectasia is associated condition of cerebellar ataxia. In Ayurveda, if the movement of any part of body disturbs it comes under Vatavyadhi. Vatavyadhi is broad terminology; Indriyagata Vata is described when Indriya loses its function. In ataxia, function of Hasta, Pada, Vani are affected. Mridu Shodhana is performed before giving the Samanya Vatavyadhi Chikitsa. In Indriyagata Vata, Nasya, Shirobasti along with Samanya Vatavyadhi Chikitsa gives satisfactory result in patient.

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Idiopathic late-onset cerebellar ataxia with cerebellar atrophy in a patient diagnosed with Chiari I malformation: a case report

Neurological Sciences ◽

10.1007/s10072-013-1469-7 ◽

2013 ◽

Vol 34 (12) ◽

pp. 2235-2237 ◽

Cited By ~ 1

Author(s):

Maria Petracca ◽

Ilaria Cerillo ◽

Silvana Montella ◽

Giovanni Cerullo ◽

Pietro Biagio Carrieri

Keyword(s):

Case Report ◽

Cerebellar Ataxia ◽

Late Onset ◽

Cerebellar Atrophy ◽

Chiari I Malformation ◽

Chiari I

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SEZ6L2 Antibody–Associated Cerebellar Ataxia Responsive to Sequential Immunotherapy

Neurology Neuroimmunology & Neuroinflammation ◽

10.1212/nxi.0000000000001131 ◽

2022 ◽

Vol 9 (2) ◽

pp. e1131

Author(s):

Ayla Mehdiyeva ◽

Aki Hietaharju ◽

Jussi Sipilä

Keyword(s):

Case Report ◽

Cerebellar Ataxia ◽

Cerebellar Atrophy ◽

Pulse Therapy ◽

Imaging Studies ◽

Steroid Pulse ◽

Level Of Functioning ◽

Dysarthric Speech ◽

Balance Problems

ObjectivesSeizure-related 6 homolog like 2 (SEZ6L2) antibody–associated ataxia is an extremely rare disease. Six patients have been reported and none of them improved significantly with immunotherapy. Herein, we present the case of a patient with cerebellar ataxia and SEZ6L2 antibodies who benefited from immunotherapy, which dramatically altered the course of her disease.MethodsWe present a case report of a 73-year-old woman with progressive balance problems. Her condition had rapidly deteriorated in the 2 weeks before the admission to our hospital leading to repeated falls and eventually left her bed-ridden.ResultsShe presented with severe trunk ataxia, bidirectional nystagmus, dysarthric speech, and persistent nausea. With the exception of cerebellar atrophy, extensive imaging studies revealed no pathology. SEZ6L2 antibodies were found in both CSF and serum. Over a period of 9 months, our patient received immunotherapy consisting of steroid pulse therapy, IV immunoglobulin infusions, rituximab, and cyclophosphamide. Consequently, her condition improved markedly, and she was discharged home from the neurologic rehabilitation unit.DiscussionOur case report shows that intense sequential immunotherapy may considerably improve level of functioning in some patients with SEZ6L2 antibody–associated cerebellar ataxia.Classification of EvidenceThis provides Class IV evidence. It is a single observational study without controls.

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Cerebellar atrophy supporting diagnosis of alcohol dependence: A case report

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1063 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S311-S311

Author(s):

F. Pavez Reyes ◽

M. Sánchez ◽

E. Moral ◽

M. Terradillos ◽

N. López ◽

...

Keyword(s):

Case Report ◽

Alcohol Dependence ◽

Cerebellar Atrophy ◽

Clinical Suspicion ◽

Gamma Glutamyl Transferase ◽

The Family ◽

Other Information ◽

Diagnostic Hypothesis ◽

Competing Interest ◽

Glutamyl Transferase

Chronic use of alcohol is a known cause of cerebellar atrophy. This finding could be a valuable diagnosis support when there are not other information sources. In this case report, we describe a 65-year-old male patient who was referred from primary care to specialized consultation because a depressive syndrome it was unresponsive to treatment with desvenlafaxine and lorazepam. In psychopathological exploration we found overvalued ideas of suffering some kind of injury and damage by the family, which oriented the diagnostic hypothesis of delusional disorder with secondary mood symptoms, although the clinical suspicion of abuse of alcohol was proposed as a differential diagnosis. The continuing minimization and denial of consumption by the patient as well as their reluctance to incorporate an external informant made that the workup was a key element to elucidate the diagnosis. We found a discrete increase in transaminases, gamma glutamyl transferase and alkaline phosphatase. Magnetic resonance imaging showed cerebellar atrophy (vermian and, in a lesser extent, in both hemispheres). Once the patient was confronted with these results, he agreed to disclose his problem, which fulfilled alcohol dependence criteria. After that, he accepted to initiate treatment and detoxification in a specialized unity.ConclusionsAlthough psychiatric diagnosis is based on the clinical features and the exclusion of associated medical conditions, in this case the workup provided support to our clinical suspicion, favouring recognition of the problem and willingness to treatment by the patient.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Poster 360 Acute Rehabilitation of a Patient with Stiff Person Syndrome (SPS) and GAD-Antibody Cerebellar Ataxia: A Case Report

PM&R ◽

10.1016/j.pmrj.2016.07.288 ◽

2016 ◽

Vol 8 (9) ◽

pp. S278-S279

Author(s):

Nicole A. Strong ◽

Nicholas F. Love ◽

Kristen M. Brusky ◽

Sara Salim

Keyword(s):

Case Report ◽

Cerebellar Ataxia ◽

Stiff Person Syndrome ◽

Acute Rehabilitation

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Immune Mediated Cerebellar Ataxia: An Unknown Manifestation of Graft-versus-Host Disease

Acta Haematologica ◽

10.1159/000494423 ◽

2018 ◽

Vol 141 (1) ◽

pp. 19-22

Author(s):

Liat Shargian-Alon ◽

Pia Raanani ◽

Uri Rozovski ◽

Tali Siegal ◽

Shlomit Yust-Katz ◽

...

Keyword(s):

Cerebellar Ataxia ◽

Graft Versus Host Disease ◽

Hematopoietic Cell Transplantation ◽

Chronic Gvhd ◽

Cerebellar Atrophy ◽

Acid Decarboxylase ◽

High Dose ◽

Host Disease ◽

Graft Versus Host ◽

Aged Woman

Neurologic complications of allogeneic hematopoietic cell transplantation (allo-HCT) include infections, cerebrovascular events, therapy-induced neurotoxicity, recurrent malignancies, and neurologic manifestations of graft-versus-host disease (GVHD). Anti-glutamic acid decarboxylase (GAD) antibody-associated cerebellar ataxia is a well-established disorder of autoimmune origin, but there are no reports in the literature of its occurrence following allo-HCT. We describe a middle-aged woman with chronic GVHD after allo-HCT who presented with a rapidly progressive cerebellar syndrome. Thorough investigation revealed only cerebellar atrophy on brain imaging and positive anti-GAD65 antibodies in serum and cerebrospinal fluid suggesting the diagnosis of anti-GAD antibody-associated cerebellar ataxia. Despite prompt treatment with high-dose corticosteroids, intravenous immunoglobulins, and rituximab, the patient’s condition rapidly deteriorated, and she died 4 months later. This case suggests that anti-GAD antibody-associated cerebellar ataxia may be a rare manifestation of chronic GVHD.

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Middle-age-onset cerebellar ataxia caused by a homozygous TWNK variant: a case report

BMC Medical Genetics ◽

10.1186/s12881-020-01002-4 ◽

2020 ◽

Vol 21 (1) ◽

Cited By ~ 2

Author(s):

Kodai Kume ◽

Hiroyuki Morino ◽

Ryosuke Miyamoto ◽

Yukiko Matsuda ◽

Ryosuke Ohsawa ◽

...

Keyword(s):

Case Report ◽

Cerebellar Ataxia ◽

Middle Age

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Ornidazole-Induced Recurrent Encephalopathy in a Chinese Man: A Rare Case Report and Literature Review

Frontiers in Neurology ◽

10.3389/fneur.2021.706094 ◽

2021 ◽

Vol 12 ◽

Author(s):

Rong Tang ◽

Jia Liang ◽

Yuanfang Li ◽

Tingting Wu ◽

Yuhao Zhang ◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Corpus Callosum ◽

Cerebellar Ataxia ◽

Drug Withdrawal ◽

Clinical Manifestations ◽

Good Prognosis ◽

Drug Discontinuation ◽

Imaging Features ◽

Mental Symptoms

Ornidazole-induced encephalopathy (OIE) is seldom seen in the clinic. In this study, we report a new case of a patient who had taken 1,000 mg ornidazole daily for nearly 4 years because of suspected diarrhea and proctitis and presented with subacute symptoms such as unsteady gait, slurred speech, and psychiatric disorder. These symptoms were significantly relieved 3 days after the patient stopped taking ornidazole. When he took this medicine again, however, similar symptoms occurred 4 months later, which were again reduced after 4 days of drug discontinuation. After the second onset, abnormal signals were identified around the aqueduct of the midbrain, around the fourth ventricle, and in the dentate nuclei of the cerebellum bilaterally. After 9 days of drug discontinuation, lesions disappeared in the magnetic resonance imaging (MRI) results. According to the clinical manifestations, imaging features, and the reduced symptoms after drug withdrawal, we clinically diagnosed the patient with OIE. This paper also reviews the literature on OIE. Only five cases (including our case) have been reported, all of whom presented with cerebellar ataxia and dysarthria and three with additional mental symptoms such as agitation and irritability. All five patients had abnormal lesions in the dentate nucleus of the cerebellum bilaterally, among whom four also had lesions in the corpus callosum and three around the periaqueduct of the midbrain. After withdrawal of ornidazole, the symptoms in all patients vanished or were alleviated, and three of them showed reduced or disappeared lesions in a head MRI reexamination. Overall, OIE has rarely been reported. Our case report and literature review show that the lesions in the cerebellum, corpus callosum, and brainstem can be reversed. The main manifestations of the lesions—cerebellar ataxia, dysarthria, and mental symptoms—quickly weaken or disappear after drug withdrawal, with good prognosis. Nevertheless, clear pathogenesis has yet to be further investigated.

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