Acute Cerebellitis in Children: A Variable Clinical Entity

Journal of Child Neurology

Volumn 33, Issue 10, 2018, Pages 675-684

  Emelifeonwu, John Amaechi ^a,b   Shetty, Jay ^b   Kaliaperumal, Chandrasekaran ^b   Gallo, Pasquale ^b   Sokol, Drahoslav ^b   Soleiman, Hamza ^a   Kandasamy, Jegajothy ^b  

^a WESTERN GENERAL HOSPITAL   (United Kingdom)

^b ROYAL HOSPITAL FOR SICK CHILDREN   (United Kingdom)

Author keywords

acute cerebellar ataxia; cerebellitis; magnetic resonance imaging; postinflammtory leucoencephalomyelitis

Indexed keywords

ANTIBIOTIC AGENT; ANTICONVULSIVE AGENT; ANTIVIRUS AGENT; CORTICOSTEROID; CYCLOPHOSPHAMIDE; DEXAMETHASONE; METHYLPREDNISOLONE; OSMOTIC DIURETIC AGENT; PREDNISOLONE; RITUXIMAB;

ACUTE CEREBELLITIS; ARTIFICIAL VENTILATION; BIHEMISPEHRIC ACUTE CEREBELLITIS; CEREBELLAR ATAXIA; CEREBELLUM DISEASE; CEREBROSPINAL FLUID; COMPUTER ASSISTED TOMOGRAPHY; ELECTROENCEPHALOGRAPHY; ENCEPHALITIS; ENDOTRACHEAL INTUBATION; EPSTEIN BARR VIRUS; FOLLOW UP; HEMICEREBELLITIS; HUMAN; IMMUNE MEDIATED INJURY; INFLAMMATION; NUCLEAR MAGNETIC RESONANCE IMAGING; PRIORITY JOURNAL; PRODROMAL SYMPTOM; REVIEW; SEROLOGY; VARICELLA ZOSTER VIRUS; ACUTE DISEASE; CHILD; COMPLICATION;

ACUTE DISEASE; CEREBELLAR DISEASES; CHILD; ENCEPHALITIS; HUMANS;

EID: 85048745086     PISSN: 08830738     EISSN: 17088283     Source Type: Journal    
DOI: 10.1177/0883073818777673     Document Type: Review

References (96)

1. Batten FE. Ataxia in childhood. Brain. 1905;28:484–505
2. Bozzola E, Bozzola M, Tozzi AE. Acute cerebellitis in varicella: a ten year case series and systematic review of the literature. Ital J Pediatr. 2014;40:57
3. Connolly AM, Dodson WE, Prensky AL, Rust RS. Course and outcome of acute cerebellar ataxia. Ann Neurol. 1994;35(6):673–679
4. Nussinovitch M, Prais D, Volovitz B. Post-infectious acute cerebellar ataxia in children. Clin Pediatr. 2003;42(7):581–584
5. Horowitz MB, Pang D, Hirsch W. Acute cerebellitis: case report and review. Pediatr Neurosurg. 1991;17:142–145
6. Asenbauer B, McConachie NS, Allcutt D. Acute near-fatal parainfectious cerebellar swelling with favourable outcome. Neuropediatrics. 1996;28(2):122–125
7. Jabbour P, Samaha E, Abi Lahoud G. Hemicerebellitis mimicking a tumour on MRI. Childs Nerv Syst. 2003;19(2):122–125
8. Coeli GNM, Da Silva GC, Tiengo RR. Acute cerebellitis with tonsillar herniation: a case report. Radiol Bras. 2012;45(4):244–246
9. Poretti A, Benson JE, Huisman TA, Boltshauser E. Acute ataxia in children: approach to the clinical presentation and role of additional investigations. Neuropediatrics. 2013;44:127–141
10. De Bruecker Y, Claus F, Demaerel P. MRI findings in acute cerebellitis. Eur Radiol. 2004;14:1478–1483
11. Salas AA, Nava A. Acute cerebellar ataxia in childhood: initial approach in the emergency department. Emerg Med J. 2010;27(12):956–957
12. Ryan MM, Engle EC. Acute ataxia in childhood. J Child Neurol. 2003;18(5):309–316
13. Gieron-Korthals MA, Westberry KR, Emmanuel PJ. Acute childhood ataxia: 10-year experience. J Child Neurol. 1994;9:381–384
14. Thakkar K, Maricich SM, Alper G, Acute ataxia in childhood: 11-year experience at a major pediatric neurology referral center. J Child Neurol. 2016; 31: 1156–1160
15. Lancella L, Esposito S, Galli ML. Acute cerebellitis in children: an eleven year retrospective multicentric study in Italy. Ital J Pediatr. 2017;43(1):54
16. Van Toorn R, Georgallis P, Schoeman J. Acute cerebellitis complicated by hydrocephalus and impending cerebral herniation. J Child Neurol. 2004;19(11):911–913
17. Marks WA, Bodensteiner JB, Bobele GB. Parainflammatory leukoencephalomyelitis: clinical and magnetic resonance imaging findings. J Child Neurol. 1988;3:205–213
18. Hurst DL, Melita S. Acute cerebellar swelling in varicella encephalitis. Paediatr Neurol. 1988;4:122–123
19. Carceller Lechón F, Duat Rodríguez A, Sirvent Cerdá SI. Hemicerebellitis: report of three paediatric cases and review of the literature. Eur J Paediatr Neurol. 2014;18(3):273–281
20. Sunaga Y, Hikima A, Takayuki O, Morikawa A. Acute cerebellar ataxia with abnormal MRI lesions after varicella vaccination Pediatr Neurol. 1995;13(4):340–342
21. Saito H, Yanagisawa T. Acute cerebellar ataxia after influenza vaccination with recurrence and marked cerebellar atrophy. Tohoku J Exp Med. 1989;158:95–103
22. Kubota M, Takahashi Y. Steroid-responsive chronic cerebellitis with positive glutamate receptor delta 2 antibody. J Child Neurol. 2008;23(2):228–230
23. Lessa R, Castillo M, Azevedo R. Neurological complications after H1N1 influenza vaccination: magnetic resonance imaging findings. Arq Neuro-psiquiatr. 2014;72(7):496–499
24. Reisner A, Hayes LL, Holland CM. Opioid overdose in a child: case report and discussion with emphasis on neurosurgical implications. J Neurosurg Pediatr. 2015;16(6):752–757
25. Mills F, MacLennan SC, Devile CJ, Saunders DE. Severe cerebellitis following methadone poisoning. Pediatr Radiol. 2008;38(2):227–229
26. Tatli O, Karaca Y, Gunaydin M. Cerebellitis developing after tricyclic antidepressant poisoning. Am J Emerg Med. 2013;31(9):1419.e3–5
27. Rando J, Szari S, Kumar G, Lingadevaru H. Methadone overdose causing acute cerebellitis and multi-organ damage. Am J Emerg Med. 2016;34(2):343.e1–3
28. Holmes G. The symptoms of acute cerebellar injuries due to gunshot injuries. Brain. 1917;40:461–535
29. Hayashi T, Ichiyama T, Kobayashi K. A case of acute cerebellar ataxia with an MRI abnormality. Brain Dev. 1989;11:435–436
30. Dimova PS, Bojinova VS, Milanov IG. Transient mutism and pathologic laughter in the course of cerebellitis. Pediatr Neurol. 2009;41:49–52
31. Krief P, Silver A, Eberhard A, Maytal J. Fifteen-year-old girl with systemic lupus erythematosus and unilateral cerebellitis. Lupus. 2010;19(8):981–984
32. Stowe RC, Karkare S, Puri V. Case report of subacute cerebellar ataxia of adolescence with long-term sequelae. J Child Neurol. 2013;28(12)1653–1660
33. Mewasingh LD, Kadhim H, Christophe C. Nonsurgical cerebellar mutism (anarthria) in two children. Pediatric Neurology. 2003;28(1):59–63
34. Nigrovic LE, Lumeng C, Landrigan C. Rotavirus cerebellitis. Clin Infect Dis. 2002;34:130
35. Shiihara T, Watanabe M, Honma A. Rotavirus associated acute encephalitis/encephalopathy and concurrent cerebellitis: report of two cases. Brain Dev. 2007;29:670–673
36. Takanashi J, Miyamoto T, Ando N. Clinical and radiological features of rotavirus cerebellitis. Am J Neuroradiol. 2010;31:1591–1595
37. Thompson MJ, Gowdie PJ, Kirkwood CD. Rotavirus cerebellitis: new aspects to an old foe? Pediatr Neurol. 2012;46(1):48–50
38. Joshi M, Harijan P, Singh N. Acute cerebellitis and mutism associated with rotavirus dirrhoeal infection Eur J Paed Neurol. 2015;19(2): S122
39. Lynch M, Lee B, Azimi P. Rotavirus and central nervous system symptoms: cause or contaminant? Case reports and review. Clin Infect Dis. 2001;33(7):932–938
40. Lee KY, Lee K-S. Elevated cerebrospinal fluid IgG index in acute cerebellitis presenting with sudden onset headache. Neurol Asia. 2014;19(2):211–213
41. Dunin-Wasowicz D, Tomaszek K, Kaczorowska M. Acquired toxoplasmosis as a rare cause of cerebellitis in immunocompetent child. Eur J Paed Neurol. 2011;15(1): S118
42. Levy EI, Harris AE, Omalu BI. Sudden death from fulminant acute cerebellitis. Pediatr Neurosurg. 2001;35:24–28
43. Shiihara T, Kato M, Konno A. Acute cerebellar ataxia and consecutive cerebellitis produced by glutamate receptor delta2 autoantibody. Brain Dev. 2007;29:254–256
44. Fritzler MJ, Zhang M, Stinton LM, Rattner JB. Spectrum of centrosome autoantibodies in childhood varicella and post-varicella acute cerebellar ataxia. BMC Pediatr. 2003;3:11
45. Langille MM, Desai J. Encephalitis due to antibodies to voltage gated potassium channel (VGKC) with cerebellar involvement in a teenager. Ann Indian Acad Neurol. 2015;18(2):238–239
46. Kato Z, Kozawa R, Teramoto T. Acute cerebellitis in primary human herpesvirus-6 infection Eur J Pediatr. 2003;162:801–803
47. Oguz KK, Haliloglu G, Alehan D, Topcu M. Recurrent pseudotumoral hemicerebellitis: neuroimaging findings. Pediatr Radiol. 2008;38:462–466
48. Lessa R, Castillo M, Azevedo R. Neurological complications after H1N1 influenza vaccination: magnetic resonance imaging findings. Arq Neuropsiquiatr. 2014;72(7):496–499
49. Kato Z, Sasai H, Funato M. Acute cerebellitis associated with rotavirus infection. World J Pediatr. 2013;9(1):87–89
50. Saavedra-Lozano J, Booth TN, Weprin BE, Ramilo O. Isolated cerebellar edema and obstructive hydrocephalus in a child with cerebral malaria. Pediatr Infect Dis J. 2001;20(9):908–911
51. Jaggi RS, Husain M, Chawla S. Diagnosis of bacterial cerebellitis: diffusion imaging and proton magnetic resonance spectroscopy. Pediatr Neurol. 2005;32(1):72–74
52. Matsukuma E, Kato Z, Orii K. Acute mumps cerebellitis with abnormal findings in MRI diffusion-weighted images. Eur J Pediatr. 2008;167(7):829–930
53. Kubota T, Suzuki T, Kitase Y. Chronological diffusion-weighted imaging changes and mutism in the course of rotavirus-associated acute cerebellitis/cerebellopathy concurrent with encephalitis/encephalopathy. Brain Dev. 2011;33:21–27
54. Kato Z, Manabe T, Teramoto T, Kondo N. Adenovirus infection mimics the cerebellitis caused by rotavirus infection. Eur J Pediatr. 2011;170(3):405–406
55. Mori T, Mori M, Kuroiwa Y. Rotavirus encephalitis and cerebellitis with reversible magnetic resonance signal changes. Pediatr Int. 2011;53(2):252–255
56. Uchida Y, Matsubara K, Morio T. Acute cerebellitis and concurrent encephalitis associated with parvovirus B19 infection. Pediatr Infect Dis J. 2012;31(4):427
57. Uchizono H, Iwasa T, Toyoda H. Acute Cerebellitis following haemolytic streptococcal infection. Pediatr Neurol. 2013:49:497–500
58. Hackett I, O’Sullivan R, Zaid AA. Acute Cerebellitis Associated with Dual Influenza A (H1N1) and B Infection. Ir Med J. 2013;106(3):87–88
59. Thabet FI, Khalil S, Naz F, Dyme IZ. Cerebellar mutism and reversible cytotoxic edema in influenza B-associated encephalopathy. Pediatr Neurol. 2013;49(6):489–492
60. Tang Y, Suddarth B, Du X, Matsumoto JA. Reversible diffusion restriction of the middle cerebellar peduncles and dentate nucleus in acute respiratory syncytial virus cerebellitis: a case report. Emerg Radiol. 2014;21:89–92
61. Suzuki S, Kaga A, Kusaka N. A case of acute cerebellitis with a unique sequential change on magnetic resonance imaging. Pediatr Neurol. 2014;51(2):279–281
62. Kashikar SV, Lakhkar B, Pandey A, Gupta A. Catastrophic Cerebellitis in an adolescent: A Case Report. Oman Med J. 2014;29(4)
63. Hegde V, Aziz Z, Kumar S. Dengue encephalitis with predominant cerebellar involvement: report of eight cases with MR and CT imaging features. Eur Radiol. 2015;25(3):719–725
64. Kornreich L, Shkalim-Zemer V, Levinsky Y. Acute cerebellitis in children: a many-faceted disease. J Child Neurol. 2016;31(8):991–997
65. Nakagawa E, Yamanouchi H, Sakuragawa N, Takashima S. Vermis lesions in acute cerebellar ataxia: a sequential imaging study. Brain Dev. 1994;16(6):488–490
66. Hayakawa H, Katoh T. Severe cerebellar atrophy following acute cerebellitis. Pediatr Neurol. 1995;12:159–161
67. Xu F, Ren SQ, Liu JY. Acute cerebellitis in identical twins. Pediatr Neurol. 2008;39(6):432–434
68. Rodríguez-Cruz PM, Janet-Signoret S, Miranda-Herrero MC. Acute hemicerebellitis in children: case report and review of literature. Eur J Paed Neurol. 2013;17(5)447–453
69. Singh P, Bhandal SK, Saggar K. Pseudotumoral hemicerebellitis with haemorrhage. J Pediatr Neurosci, 2012;7:49–51
70. Roldan H, Garcia-Conde M, Ginoves-Sierra M, Rodriguez R. Acute hemicerebellitis with obstructive hydrocephalus in a young adult. World Neurosurg. 2011;75:726–730
71. Murthy JM, Kishore LT. MR findings in cerebellar ataxia after enteric fever. J Comput Assis Tomogr. 1997;21:216–217
72. Komatsu H, Kuroki S, Shimizu Y. Mycoplasma pneumoniae meningoencephalitis and cerebellitis with antiganglioside antibodies. Pediatr Neurol. 1998;18:160–164
73. Sawaishi Y, Takahashi I, Hirayama Y. Acute cerebellitis caused by coxiella burnetii. Ann Neurol. 1999;45:124–127
74. Ciardi M, Giacchetti G, Fedele CG. Acute cerebellitis caused by herpes simplex virus type 1. Clin Infect Dis. 2003;36: e50–e54
75. Drost G, Verrips A, Thijssen HO, Gabreëls. Cerebellar involvement as a rare complication of pneumococcal meningitis. Neuropediatrics. 2000;31(2):97–99
76. Hirayama K, Sakazaki H, Murakami S. Sequential MRI, SPECT and PET in respiratory syncytial virus encephalitis. Pediatric Radiology. 1999;29:282
77. Vitaszil E, Kamondi A, Csillik A. Asymptomatic cerebellar atrophy after acute enteroviral encephalitis. Dev Med Child Neurol. 2005;47(7):486–488
78. Kamate M, Chetal V, Hattiholi V. Fulminant cerebellitis: a fatal, clinically isolated syndrome. Paed Neurol. 2009;41(3):220–222
79. Lankford J, Butler IJ. Transient tonic upgaze deviation: a neuro-ophthalmological complication of acute cerebellitis. J Child Neurol. 2013;28(7):942–944
80. Alberini E, Vellante V, Zennaro F. Acute pseudotumoral hemicerebellitis in a child: a rare and distinct entity? J Child Neurol. 2015;30(4):496–499
81. Kato Z, Shimozawa N, Kokuzawa J. Magnetic resonance imaging of acute cerebellar ataxia: report of a case with gadolinium enhancement and review of the literature. Acta Paediatr Jpn. 1998;40:138–142
82. Gruis KL, Moretti P, Gebarski SS, Mikol DD. Cerebellitis in an adult with abnormal magnetic resonance imaging findings prior to the onset of ataxia. Arch Neurol. 2003;60(6):877–880
83. Koul R, Al-Omairi AHM, Rahim RA. Magnetic resonance imaging abnormalities in a child with acute cerebellitis. Sultan Qaboos Univ Med J. 2015;15(4): e563–e564
84. De Ribaupierre S, Meagher-Villemure K, Villemure JG. The role of posterior fossa decompression in acute cerebellitis. Childs Nerv Syst. 2005;21:970–974
85. Fantacci C, Bersani G, Valentini P. Acute pediatric cerebellitis and mutism case report and review of the literature. Signa Vitae. 2011;6(2):78–81
86. Wagel J, Gruszka J, Szewczyk P. Herniation to foramen magnum in the course of cerebellitis in a 4-year-old boy, as shown by CT and MRI—case report. Pol J Rad. 2010;75(3):42–46
87. Roulet Perez E, Maeder P, Cotting J. Acute fatal parainfectious cerebellar swelling in two children. Neuropediatrics. 1993;24(6):346–351
88. van der Maas NA, Bondt PE, de Melker H, Kemmeren JM. Acute cerebellar ataxia in the Netherlands: a study on the association with vaccinations and varicella zoster infection. Vaccine. 2009;27(13):1970–1973
89. Meszner Z, Molnar Z, Yang HK. Economic burden of varicella in children 1-12 years of age in Hungary, 2011-2015. BMC Infect Dis. 2017;17:495
90. Thong WY, Han A, Wang SJ. Enterovirus infections in Singaporean children: an assessment of neurological manifestations and clinical outcomes. Singapore Med J. 2017;58(4):189–195
91. Mazur-Melewska K, Breńska I, Jończyk-Potoczna K. Neurologic complications caused by Epstein-Barr virus in pediatric patients. J Child Neurol. 2016;31(6):700–708
92. Kammer J, Ziesing S, Davila LA. neurological manifestations of mycoplasma pneumoniae infection in hospitalized children and their long-term follow-up. Neuropediatrics. 2016;47(5):308–317
93. Al-Zaidy SA, MacGregor D, Mahant S. Neurological complications of PCR proven M. pneumoniae infections in children: prodromal illness duration may reflect pathogenetic mechanism. Clin Infect Dis. 2015;61(7):1092–1098
94. Huang YC, Chu YH, Yen TY. Clinical features and phylogenetic analysis of coxsackievirus A9 in Northern Taiwan in 2011. BMC Infect Dis. 2013;13:33
95. Chan JY, Tian L, Kwan Y. Hospitalizations for varicella in children and adolescents in a referral hospital in Hong Kong, 2004 to 2008: a time series study. BMC Public Health. 2011;11:366
96. Tabarki B, Husson B, Landrieu P. Acute cerebellar atrophy in encephalitis. J Child Neurol. 1998;13:192–195