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August 1, 2024

We discuss a case of ataxia in children and how to approach the evaluation of these pts.

Hosts:
Ellen Duncan, MD, PhD
Brian Gilberti, MD

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Show Notes

Introduction

  • The episode focuses on ataxia in children, which can range from self-limiting to life-threatening conditions.
  • Pediatric emergency medicine specialist shares insights on the topic.

The Case

  • An 18-month-old boy presented with ataxia, unable to keep his head up, sit, or stand, and began vomiting.
  • Previously healthy except for recurrent otitis media and viral-induced wheezing.
  • The decision to take the child to the emergency department (ED) was based on acute symptoms.

Differential Diagnosis

  • Common causes include acute cerebellar ataxia, drug ingestion, Guillain-Barre syndrome, and basilar migraine.
  • Less common causes include cerebellitis, encephalitis, brain tumors, and labyrinthitis.

Importance of History and Physical Examination

  • A detailed history and physical exam are essential in diagnosing ataxia.
  • Key factors include time course, recent infections, signs of increased intracranial pressure, and toxic exposures.
  • Look for signs such as bradycardia, hypertension, vomiting, and overall appearance.

Diagnostic Workup

  • Initial tests include point-of-care glucose and neuroimaging for concerns about trauma or increased intracranial pressure.
  • MRI is preferred for posterior fossa abnormalities,
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