Algorithmic approach to acute ataxia in children*

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