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Symptoms and Signs - Differential Diagnosis of Acute or Recurrent Ataxia
• Vascular events (e.g., cerebellar hemorrhage or stroke)
• Seizure (ictal or postictal)
• Postinfectious (cerebellitis [e.g., varicella], acute disseminated encephalomyelitis)
• Multiple sclerosis
• Miller-Fisher variant of Guillain-Barré syndrome (ataxia, ophthalmoplegia, and areflexia). WARNING: If bulbar signs are present, disease is likely progressive; patient may lose ability to protect airway or ability to breathe.
• Inherited ataxias
• Infection (e.g., labyrinthitis, abscess)
• Inborn errors of metabolism (e.g., mitochondrial disorders,aminoacidopathies, urea cycle defects)
• Hydrocephalus
• Head trauma
• Drug ingestion (e.g., phenytoin, carbamazepine, sedatives, hypnotics, and phencyclidine) or intoxication (e.g., alcohol, ethylene glycol, hydrocarbon fumes, lead, mercury, or thallium)
• Conversion reaction
• Brain tumor or neuroblastoma (if accompanied by opsoclonus or myoclonus [i.e., “dancing eyes, dancing feet”])
• Benign paroxysmal vertigo (migraine equivalent)
• Basilar migraine
• Vascular events (e.g., cerebellar hemorrhage or stroke)
• Seizure (ictal or postictal)
• Postinfectious (cerebellitis [e.g., varicella], acute disseminated encephalomyelitis)
• Multiple sclerosis
• Miller-Fisher variant of Guillain-Barré syndrome (ataxia, ophthalmoplegia, and areflexia). WARNING: If bulbar signs are present, disease is likely progressive; patient may lose ability to protect airway or ability to breathe.
• Inherited ataxias
• Infection (e.g., labyrinthitis, abscess)
• Inborn errors of metabolism (e.g., mitochondrial disorders,aminoacidopathies, urea cycle defects)
• Hydrocephalus
• Head trauma
• Drug ingestion (e.g., phenytoin, carbamazepine, sedatives, hypnotics, and phencyclidine) or intoxication (e.g., alcohol, ethylene glycol, hydrocarbon fumes, lead, mercury, or thallium)
• Conversion reaction
• Brain tumor or neuroblastoma (if accompanied by opsoclonus or myoclonus [i.e., “dancing eyes, dancing feet”])
• Benign paroxysmal vertigo (migraine equivalent)
• Basilar migraine
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