Acute cerebellar ataxia: differential diagnosis and clinical approach

José Luiz Pedroso; Thiago Cardoso Vale; Pedro Braga-Neto; Lívia Almeida Dutra; Marcondes Cavalcante França Jr; Hélio A. G. Teive; Orlando G. P. Barsottini

doi:10.1590/0004-282X20190020

Arquivos de Neuro-Psiquiatria, Inhaltsverzeichnis

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2019; 77(03): 184-193
DOI: 10.1590/0004-282X20190020

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Acute cerebellar ataxia: differential diagnosis and clinical approach

Ataxia cerebelar aguda: diagnóstico diferencial e abordagem clínica

José Luiz Pedroso ^*

¹Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil

,

Thiago Cardoso Vale ^*

²Universidade Federal de Juiz de Fora, Departamento de Clínica Médica, Serviço de Neurologia do Hospital Universitário, Juiz de Fora MG, Brasil

,

Pedro Braga-Neto

³Universidade Federal do Ceará, Departamento de Medicina Clínica, Divisão de Neurologia, Fortaleza CE, Brasil

⁴Universidade Estadual do Ceará, Centro de Ciências da Saúde, Fortaleza CE, Brasil

,

Lívia Almeida Dutra

¹Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil

⁵Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo SP, Brasil

,

Marcondes Cavalcante França Jr

⁶Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil

,

Hélio A. G. Teive

⁷Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Medicina Interna, Serviço de Neurologia, Setor de Distúrbios do Movimento, Curitiba PR, Brasil

,

Orlando G. P. Barsottini

¹Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil

› Institutsangaben

Abstract

ABSTRACT

Cerebellar ataxia is a common finding in neurological practice and has a wide variety of causes, ranging from the chronic and slowly-progressive cerebellar degenerations to the acute cerebellar lesions due to infarction, edema and hemorrhage, configuring a true neurological emergency. Acute cerebellar ataxia is a syndrome that occurs in less than 72 hours, in previously healthy subjects. Acute ataxia usually results in hospitalization and extensive laboratory investigation. Clinicians are often faced with decisions on the extent and timing of the initial screening tests, particularly to detect treatable causes. The main group of diseases that may cause acute ataxias discussed in this article are: stroke, infectious, toxic, immune-mediated, paraneoplastic, vitamin deficiency, structural lesions and metabolic diseases. This review focuses on the etiologic and diagnostic considerations for acute ataxia.

RESUMO

A ataxia cerebelar é um achado comum na prática neurológica e tem uma grande variedade de causas, desde a degeneração cerebelar crçnica e lentamente progressiva à lesão cerebelar aguda devido a infarto, edema ou hemorragia, configurando uma verdadeira emergência neurológica. Ataxia cerebelar aguda é uma síndrome que ocorre em menos de 72 horas em indivíduos previamente saudáveis. A ataxia aguda geralmente resulta em hospitalização e extensa investigação laboratorial. Os clínicos são frequentemente confrontados com a decisão sobre a extensão e o momento dos testes de rastreio iniciais, em particular para detectar as causas tratáveis. O principal grupo de doenças que podem causar ataxias agudas discutidas neste artigo são: acidente vascular cerebral, infecciosas, tóxicas, imunomediadas, paraneoplásicas, deficiência de vitaminas, lesões estruturais e doenças metabólicas. Esta revisão enfoca a etiologia e considerações diagnósticas para a ataxia aguda.

Keywords:

Cerebellar ataxia - cerebellum - cerebellar diseases

Palavras-chave:

Ataxia cerebelar - cerebelo - doenças cerebelares

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Referenzen

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