Objective: The aim of our study is to define the most common clinical presentations, etiology and predictive factors of poor outcome in children presenting with acute ataxia (AA) amoung a Tunisian population.

Background: Acute ataxia in children represents a clinical reflection of a broad spectrum of diseases having a wide array of clinical presentations and outcome. It represents about 0.02% of pediatric emergency department admissions. Yet, poor data are available on its etiology and possible outcome, especially in developing countries.

Method: We conducted a retrospective descriptive study including patients who were hospitalized at the department of pediatric neurology at the National Institute of Neurology of Tunisia, between 2005-2024, having a diagnosis of AA and a minimal follow-up period of six months. The outcome was assessed at the end of hospitalization and was defined as complete or incomplete recovery evaluated through the the SARA (Scale for Assessment and Rating of Ataxia) score.

Results: The study included 71 children, with a mean age of 5.27 ± 3.58 years. Mean SARA score on admission was 8.7 ± 3.89. The most frequent causes of AA were post infectious cerebellitis (60.6%), para-infectious cerebellitis (18.3%), followed by paraneoplastic causes (8.5%) (5 cases of Kinsbourne syndrome and 1 case of lymphoma), Episodic Ataxia (AE)(7%) and intoxication (5.6%). Mean SARA score at 6 months was 0.79 ± 2.07. Complete recovery was noted in the presence of benign etiologies such as intoxication (100%) and EA (100%) (p= 0.002). The group with the most motor sequelae was paraneoplastic causes (83.3%), followed by post-infectious cerebellitis (28.2%) (p=0.003). Poor outcome was correlated with the presence of headache (p=0.032), myoclonia (p=0.041), visual impairment (p<0.001), imaging structural abnormalities (p=0.025), Etiology wise, the group with the most motor sequelae was paraneoplastic causes (83.3%), with post-infectious cerebellitis (22.8%) being the second highest (p= 0.003).

Conclusion: The most frequent cause of AA in our cohort is post infectious cerebellitis. In most cases, complete recovery occurred. Nevertheless, AA can be a gateway to other diseases with high mortality such as neoplasm or paraneoplastic phenomena. Therefore, particular attention must be paid to the initial neurological examination and imaging findings.

« Back to 2024 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/acute-ataxia-in-children-a-north-african-single-center-experience/