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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    *
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil
,
Thiago Cardoso Vale    *
2   Universidade Federal de Juiz de Fora, Departamento de Clínica Médica, Serviço de Neurologia do Hospital Universitário, Juiz de Fora MG, Brasil
,
Pedro Braga-Neto 
3   Universidade Federal do Ceará, Departamento de Medicina Clínica, Divisão de Neurologia, Fortaleza CE, Brasil
4   Universidade Estadual do Ceará, Centro de Ciências da Saúde, Fortaleza CE, Brasil
,
Lívia Almeida Dutra 
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil
5   Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo SP, Brasil
,
Marcondes Cavalcante França  Jr
6   Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brasil
,
Hélio A. G. Teive 
7   Universidade 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 
1   Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil
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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

* These authors contributed equally to this work.




Publication History

Received: 18 September 2018

Accepted: 02 December 2018

Article published online:
21 August 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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