Etiology of Cerebellar Ataxia

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 drugs Alcoholic-nutritional (vitamin B₁ and B₁₂ deficiency) Lyme disease	Paraneoplastic syndrome Antigliadin antibody syndrome Hypothyroidism Inherited diseases Tabes dorsalis (tertiary syphilis) Phenytoin toxicity Amiodarone	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)

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 drugs

Alcoholic-nutritional (vitamin B₁ and B₁₂ deficiency)

Lyme disease

Paraneoplastic syndrome

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)

Abbreviations: CSF, cerebrospinal fluid; CT, computed tomography; MRI, magnetic resonance imaging.