Etiology of Cerebellar Ataxia
| Symmetric and Progressive Signs | Focal and Ipsilateral Cerebellar Signs | ||||
|---|---|---|---|---|---|
| Acute (Hours to Days) | Subacute (Days to Weeks) | Chronic (Months to Years) | Acute (Hours to Days) | Subacute (Days to Weeks) | Chronic (Months to Years) |
Intoxication: alcohol, lithium, phenytoin, barbiturates (positive history and toxicology screen) Acute viral cerebellitis (CSF supportive of acute viral infection) Postinfection syndrome | Intoxication: mercury, solvents, gasoline, glue; cytotoxic chemotherapeutic, hemotherapeutic drugs Alcoholic-nutritional (vitamin B1 and B12 deficiency) Lyme disease | Paraneoplasticsyndrome Antigliadin antibody syndrome Hypothyroidism Inherited diseases Tabes dorsalis (tertiary syphilis) Phenytoin toxicity | Vascular: cerebellar infarction, hemorrhage, or subdural hematoma Infectious: cerebellar abscess (mass lesion on MRI/CT, history in support of lesion) | Neoplastic: cerebellar glioma or metastatic tumor (positive for neoplasm on MRI/CT) Demyelinating: multiple sclerosis (history, CSF, and MRI are consistent) AIDS-related multifocal leukoencephalopathy (positive HIV test and CD4+ cell count for AIDS) | Stable gliosis secondary to vascular lesion or demyelinating plaque (stable lesion on MRI/CT older than several months) Congenital lesion: Chiari or Dandy-Walker malformations (malformation noted on MRI/CT) |