Book contents
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Foreword by Sid Gilman
- PART I INTRODUCTION
- PART II THEORIES OF CEREBELLAR CONTROL
- PART III CLINICAL SIGNS AND PATHOPHYSIOLOGICAL CORRELATIONS
- PART IV SPORADIC DISEASES
- 10 Congenital malformations of the cerebellum and posterior fossa
- 11 Multiple system atrophy and idiopathic late-onset cerebellar ataxia
- 12 Corticobasal degeneration
- 13 Cerebellar stroke
- 14 Immune diseases
- 15 Infectious diseases: radiology and treatment of cerebellar abscesses
- 16 Other infectious diseases
- 17 Cerebellar disorders in cancer
- 18 Posterior fossa trauma
- 19 Thyroid hormone and cerebellar development
- 20 Endocrine disorders: clinical aspects
- PART V TOXIC AGENTS
- PART VI ADVANCES IN GRAFTS
- PART VII NEUROPATHOLOGY
- PART VIII DOMINANTLY INHERITED PROGRESSIVE ATAXIAS
- PART IX RECESSIVE ATAXIAS
- Index
16 - Other infectious diseases
from PART IV - SPORADIC DISEASES
Published online by Cambridge University Press: 06 July 2010
- Frontmatter
- Contents
- List of contributors
- Preface
- Acknowledgments
- Foreword by Sid Gilman
- PART I INTRODUCTION
- PART II THEORIES OF CEREBELLAR CONTROL
- PART III CLINICAL SIGNS AND PATHOPHYSIOLOGICAL CORRELATIONS
- PART IV SPORADIC DISEASES
- 10 Congenital malformations of the cerebellum and posterior fossa
- 11 Multiple system atrophy and idiopathic late-onset cerebellar ataxia
- 12 Corticobasal degeneration
- 13 Cerebellar stroke
- 14 Immune diseases
- 15 Infectious diseases: radiology and treatment of cerebellar abscesses
- 16 Other infectious diseases
- 17 Cerebellar disorders in cancer
- 18 Posterior fossa trauma
- 19 Thyroid hormone and cerebellar development
- 20 Endocrine disorders: clinical aspects
- PART V TOXIC AGENTS
- PART VI ADVANCES IN GRAFTS
- PART VII NEUROPATHOLOGY
- PART VIII DOMINANTLY INHERITED PROGRESSIVE ATAXIAS
- PART IX RECESSIVE ATAXIAS
- Index
Summary
CEREBELLITIS
Cerebellitis is an inflammatory process characterized by an acute or subacute onset of cerebellar ataxia following an infection, in general of viral origin. The primary infection occurs usually at the level of the gastrointestinal tract or the respiratory airways (Cohen and Lipton, 1990 Klockgether et al., 1993). Ataxia may also appear after the skin rash of an exanthematous infection or after a vaccination.
Most frequently, cerebellitis is observed in children aged one to six years and in young adults, although ataxia may also develop in the elderly. In children, it is estimated that about 0.05–0.10% of all children with varicella infection present cerebellar ataxia. Cerebellitis in young adults affects males more than female, with a M/F ratio varying from 2:1 up to 4.3 :1. In some series, a marked predominance of males has been observed (Klockgether et al., 1993).
Clinical presentation
Body temperature is not a reliable clinical sign, and fever may have completely disappeared at the time of neurological presentation (Cleary et al., 1980). Ataxia appears within several hours, several days or develops slowly over a period of one to four weeks. The cerebellar syndrome is isolated or appears as part of a diffuse inflammatory complication in the brain (Table 16.1). In children, the most frequent picture is an association of sudden limb clumsiness and gait unsteadiness with muscle hypotonia. Overall, limb ataxia is accompanied in 75% of cases by oculomotor disturbances. Figure 16.1A illustrates the cerebellar signs observed during the acute stage in a series including nine patients aged 12 to 64 presenting cerebellitis in the absence of clinical evidence of extracerebellar involvement. Relative frequencies of different types of oculomotor deficits are shown in Fig. 16.1B.
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- The Cerebellum and its Disorders , pp. 248 - 264Publisher: Cambridge University PressPrint publication year: 2001