A Case of Post Varicella Acute Cerebellar Ataxia

Abstract

Acute cerebellitis (AC) is the most common neurological complication of varicella and occurs about once in 4000 varicella case among children. This is a case of a two and half old female child, who presented with acute onset of generalized weakness and swaying while walking, accompanied by slurring of speech .There was also history of headache and vomiting for past 2-3 days. The child also gave a history of pink to red papules over the body 7 days back associated with fever for 3-4 days 8 days back. On examination child was vitally stable, skin showed multiple small scars, some with scabs, a manifestation of recent varicella infection. There were no new lesions. On central nervous examination child had ataxic gait, conscious but clumsy, with power of grade IV in all four limbs, decreased muscle tone, deep tendon reflexes and plantar responses were normal.  She had intentional tremor, slurred speech and finger nose test positive. Routine blood tests were normal. Vitamin B12 was in normal range. CSF was clear fluid with 1-2 WBC/cmm  with lymphocytic predominance and no microorganisms on gram stain. Thyroid function tests were normal. CT scan of brain was normal. HIV serology was non-reactive. A diagnosis of post varicella acute cerebellitis was made.