Pediatric emergency medicine trisk 0412 0412

TABLE 15.3
DRUGS AND TOXINS THAT MAY CAUSE ATAXIA
Benzodiazepines
Alcohol
Dextromethorphan
Marijuana and synthetic cannabinoids
Phenytoin
Carbamazepine
Tricyclic antidepressants
Antihistamines
Lead
5-Fluorouracil
Ethylene glycol
Primidone
Phenothiazines
Topiramate
Risperidone
Gabapentin
Phenobarbital
GBS is a postinfectious polyneuropathy with a peak incidence at ages 5 to 6
years that can cause ataxia, and must be considered in a patient presenting with
areflexia and weakness, particularly the classic presentation of ascending
paralysis and weakness. CSF analysis, particularly assessing for elevated protein
in the CSF, is key in diagnosing GBS. The clinician must also consider Miller
Fisher variant, which has more severe and more rapid onset than GBS, and
classically presents with ataxia, areflexia, and ophthalmoplegia. CSF pleocytosis
can also be seen with this illness; however, for definitive testing and diagnosis,
neurology consultation should be considered.
A rare but severe cause for acute ataxia is stroke , either hemorrhagic or
ischemic. Cerebellar bleeding in children can be associated with arteriovenous
malformations or cavernous hemangiomas and often presents with severe

headache and signs of increased intracranial pressure (ICP). Posterior circulation