Algorithmic approach to acute ataxia in children^*

ADEM: acute disseminated encephalomyelitis; CNS: central nervous system; CSF: cerebrospinal fluid; CT: computed tomography; ICP: intracranial pressure; LP: lumbar puncture; MRI: magnetic resonance imaging.

* Refer to the UpToDate topics on the approach to acute ataxia in children for further details.

¶ MRI is preferred over CT if available in a timely fashion.

Δ Signs of increased ICP include papilledema, headache, and/or vomiting.

◊ Acute stroke may be present despite normal CT. If suspected, MRI should be performed.

§ Acute cerebellar ataxia is a diagnosis of exclusion. Additional evaluation (eg, neuroimaging and/or CSF examination) may be warranted in some cases. Refer to the UpToDate topics on the approach to ataxia in children and acute cerebellar ataxia in children for further details.

¥ If functional neurological symptom disorder (conversion disorder) is under consideration, there should be characteristic features on examination. Pediatric neurologic consultation is advised. Refer to UpToDate content on evaluation and diagnosis of conversion disorder for further details.