Acute cerebellar ataxia: a rare presentation of scrub typhus in pediatric age group

Scrub typhus is known to cause local and systemic vasculitic response in almost all the systems of the body. Scrub typhus very rarely presents itself with CNS manifestations. In central nervous system it most commonly causes meningitis and encephalitis although several other atypical presentations have been documented. Cerebellar ataxia, which is the lack of coordination, has a number of causes none of which are as uncommon or unheard of as Scrub Typhus. We report a case of a 15 years old child presenting with fever and isolated acute cerebellitis. Scrub Typhus was diagnosed by serum IgM ELISA. Patient showed rapid response to doxycycline therapy.

Acute cerebellar ataxia and peripheral neuropathy due to an atypical infection

This 18-year-old boy presented to the hospital with symptoms of cerebellar dysfunction preceded by an acute febrile illness with rash. Examination showed evidence of left-sided cerebellar dysfunction and polyneuropathy. Empirical treatment for leptospirosis and scrub typhus was initiated. MRI was normal. Other organ dysfunctions in the form of thrombocytopenia and transaminitis were also observed. He recovered without sequelae. A diagnosis of acute cerebellar ataxia and polyneuropathy due to scrub typhus was made.

Acute Ataxia in a Child

The differential diagnosis for acute ataxia is reviewed, including the most common explanation, a benign, self-limited postinfectious acute cerebellar ataxia.

Cerebellar ataxia as a primary manifestation of neuropsychiatric systemic lupus erythematosus

Acute cerebellar ataxia is a rare primary manifestation of neuropsychiatric systemic lupus erythematosus (NPSLE). We report a case of a 22-year-old woman who presented with gait instability, behavioural changes and new-onset seizures. The tempo of disease progression was explained by an autoimmune cause, eventually fulfilling the criteria for systemic lupus erythematosus. The patient’s neurological symptoms improved markedly following administration of steroids and immunomodulators. A review of literature on cerebellar ataxia in NPSLE and a summary of all reported cases to date are also presented.

Anti-GFAP-antibody positive postinfectious acute cerebellar ataxia and myoclonus after COVID-19: a case report

We present a case of acute cerebellar ataxia and myoclonus with detected anti-GFAP-antibodies in a patient recently recovered from COVID-19. Main symptoms consisted of acute gait and limb ataxia and myoclonus. The patient improved considerably upon treatment with high-dose intravenous (IV) steroids. While cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) findings were unremarkable, anti-GFAP-antibodies were detected in the patient’s serum and disappeared upon clinical remission at a 3-month follow-up. This case suggests that anti-GFAP-antibodies might be associated with some of the increasingly observed cases of postinfectious acute cerebellar ataxias in COVID-19 patients and aid in the diagnosis of this autoimmune complication. We recommend searching for these antibodies in serum and CSF in suspected cases. Early steroid treatment may prove beneficial for these patients.