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Etiologies of Acute Ataxia in Children: A Systematic Review of 1167 Subjects

Collin Jones¹, Paige Amendum¹, Michael DelVecchio²

¹Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.

Journal of Child Neurology

|December 1, 2025

Insights

This review offers a diagnostic hierarchy for pediatric acute ataxia. Postinfectious cerebellitis and drug intoxication are the most frequent causes in children.

Area of Science:

Pediatric Neurology
Neuroscience
Systematic Review and Meta-Analysis

Background:

Acute ataxia presents a diagnostic challenge in pediatrics due to diverse causes.
A structured approach is needed to efficiently diagnose pediatric acute ataxia.

Conclusions:

The study provides a data-driven hierarchy for diagnosing pediatric acute ataxia.
Common etiologies like postinfectious cerebellitis and intoxication should be prioritized in differential diagnosis.
This approach aids clinicians in managing pediatric acute ataxia effectively.

Read full analysis

Abstract:

Acute ataxia is a pediatric condition associated with a plethora of etiologies. This systematic review with meta-analysis was undertaken to provide a hierarchal approach to the differential diagnosis of acute ataxia in the pediatric population. Eleven studies, consisting of 1167 children, met inclusion criteria of 10 or more patients, multiple etiologies of ataxia, and diagnostic data including number of patients with each condition. Extracted data were summarized and expected values (EVs) and 95% credible intervals for each disease entity were estimated using a Bayesian methodology. Postinfectious cerebellitis (EV, 38.0%; 95% CredI, 35.3-40.8%), drug intoxication/poisoning (EV, 14.1%; 95% CredI, 12.1-16.1%), central nervous system infection or inflammation (EV, 8.1%; 95% CredI, 6.6-9.8%), neoplasm (EV 7.3%; 95% CredI, 5.9-8.8%), and peripheral neuropathies including Guillain-Barré syndrome (EV, 6.6%; 95% CredI, 5.3-8.1) occurred most commonly and accounted for 74.1% of cases.

Keywords:

ataxia diagnosis pediatrics

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