acyclovir and Cerebellar-Ataxia

Acute cerebellar ataxia of childhood is the most frequent neurological complication of chickenpox virus infection. Acute cerebellar ataxia is categorized within the group of acute postinfectious complications. The aims of this study were: (I) to evaluate the clinical presentation, management, and follow-up of children hospitalized due to acute cerebellar ataxia in a tertiary pediatric hospital, where immunization for chickenpox is not available, and (II) to describe the differential diagnosis of acute postinfectious cerebellitis. We evaluated 95 patients with acute cerebellar ataxia. The diagnostic criteria for acute ataxia were: Acute-onset loss of coordination or gait difficulties, with or without nystagmus, lasting less than 48 hours in a previously healthy child. All children met the inclusion criteria, except those with drug-induced ataxia in whom duration should be less than 24 hours for inclusion in the study. The data were recorded in a clinical pediatrics and neurological chart. Among immunosuppressed patients acute cerebellar ataxia was most frequently due to chickenpox. Most of the patients were male. Age at presentation ranged from preschool to 5 years of age. Time lapse between presentation of the rash and hospital admission ranged from 1 to 3 days. CSF study was performed in 59.5% of the cases. Brain magnetic resonance imaging and computed tomography scan showed edema in 33.3%. Intravenous acyclovir was used in 23 patients, however, no significant differences were found in clinical manifestations and follow-up between treated and untreated patients. Ataxia was the first clinical manifestation. Mean hospital stay ranged from 2 to 11 days with a mean of 4 days.

Topics: Acute Disease; Acyclovir; Antiviral Agents; Cerebellar Ataxia; Child; Diagnosis, Differential; Female; Humans; Male; Retrospective Studies; Time Factors

The varicella zoster virus (VZV) is a ubiquitous, neurotropic pathogen capable of reactivation from sensory ganglion cells to cause dermatomal herpes zoster infection, alongside a range of pathologies within the central nervous system. The presence of VZV cerebellitis without skin manifestations, however, is exceedingly rare in immunocompetent adults.We report a case of VZV cerebellitis in an immunocompetent woman in her 70s, in the absence of a rash. The patient presented with a 2-week history of progressive gait ataxia, headache and mild confusion. Serological tests and neuroimaging were unremarkable. Diagnosis was confirmed through cerebrospinal fluid (CSF) analysis which revealed lymphocytosis and the presence of VZV DNA on PCR analysis. The patient showed symptomatic improvement following empirical acyclovir treatment, corroborated by favourable CSF analysis 10 days post-treatment initiation.Infective aetiology, including VZV, should be considered in patients presenting with acute cerebellar ataxia, even in immunocompetent adults with an absence of dermatological signs.

Topics: Acyclovir; Adult; Central Nervous System; Cerebellar Ataxia; Female; Herpes Zoster; Herpesvirus 3, Human; Humans

Topics: Acute Disease; Acyclovir; Adrenal Cortex Hormones; Antiviral Agents; Cerebellar Ataxia; Cerebellar Diseases; Child; Consciousness Disorders; COVID-19; COVID-19 Drug Treatment; COVID-19 Nucleic Acid Testing; Drainage; Encephalitis, Viral; Headache; Humans; Hydrocephalus; Male; Nasopharynx; Neuroimaging; SARS-CoV-2

Topics: Acute Disease; Acyclovir; Adult; Antibodies, Viral; Antiviral Agents; Cerebellar Ataxia; Female; Humans; Immunocompetence; West Nile Fever; West Nile virus

Cerebellar ataxia is a common neurological presentation. It can be acute, subacute or chronic. Neurological complications of Epstein-Barr virus (EBV) are well-recognised with a variety of presentations. Acute cerebellar ataxia is a rare, but an established complication. It has been described as the sole manifestation of EBV infection without the systemic features of infectious mononucleosis. The pathophysiology is not clear. The course of the illness may last for a few months with a benign outcome, though serious complications can happen. We present a case of a 38-year-old man who presented with an acute cerebellar ataxia owing to EBV infection, along with a review of the literature.

Topics: Acyclovir; Adult; Antiviral Agents; Cerebellar Ataxia; Diagnosis, Differential; Epstein-Barr Virus Infections; Humans; Male

Topics: Acyclovir; Aged; Antiviral Agents; Cerebellar Ataxia; Diagnosis, Differential; Encephalitis, Viral; Female; Humans

Topics: Acyclovir; Adult; Anti-Inflammatory Agents; Antiviral Agents; Cerebellar Ataxia; Combined Modality Therapy; Encephalitis, Viral; Humans; Immunoglobulins, Intravenous; Infectious Mononucleosis; Male; Methylprednisolone; Nystagmus, Pathologic

Topics: Acute Disease; Acyclovir; Adult; Antiviral Agents; Cerebellar Ataxia; Diagnosis, Differential; Female; Herpesvirus 3, Human; Humans; Risk Factors

Central nervous system manifestations represent 0.54 to 8% of neurological complication in Lyme disease.. A 78-year-old woman presented a severe meningo-encephalitis with visual disorders (agnosia, alexia) progressing towards coma. Cranial magnetic resonance imaging revealed large areas of hypersignal T2 in the white matter of the lower, parieto-occipital lobes and left temporal lobe. The cerebrospinal fluid (CSF) contained 16 then 293 white corpuscles/mm3 of lympho-monocytes, increased protein level from 2.67 to 5.83 g/l and an increase in IgG index with oligoclonal distribution of IgG. Serological Elisa analysis for Lyme disease was slightly positive in blood (confirmed by western blot) but clearly in the CSF (IgG and IgM). Treatment with ceftriaxone followed by methylprednisolone provided clinical improvement 3 months later.. Acute meningo-encephalitis is often benign, protein-like and of good prognosis: the gnosic visual disorders with posterior leukoencephalopathy are unusual. A blood level of specific antibodies slightly positive on Elisa at the early stage of the infection warrants confirmation by Western blot in the blood and by Elisa in the CSF. Additional corticosteroid therapy may be required in the severe forms that evoke acute disseminated encephalomyelitis.

Topics: Acyclovir; Aged; Agnosia; Antibodies, Bacterial; Blotting, Western; Borrelia burgdorferi; Ceftriaxone; Cerebellar Ataxia; Cerebral Cortex; Diagnosis, Differential; Dominance, Cerebral; Drug Therapy, Combination; Dyslexia; Enzyme-Linked Immunosorbent Assay; Female; Humans; Immunoglobulin G; Immunoglobulin M; Lyme Neuroborreliosis; Magnetic Resonance Imaging; Methylprednisolone; Neurologic Examination

In adults, neurological complications of VZV virus usually occur after herpes zoster infection in patients with AIDS. We report a case of acute and benign cerebellar ataxia after chickenpox in a patient without immunodeficiency.

Topics: Acyclovir; Adult; Cerebellar Ataxia; Chickenpox; Encephalitis, Viral; Humans; Male; Neurologic Examination

Topics: Acyclovir; Cerebellar Ataxia; Herpes Zoster; Humans; Myoclonic Cerebellar Dyssynergia