Sorting out childhood ataxias

Abstract

Ataxia is a somewhat unusual complaint in children, and the differential diagnosis is daunting. From the standpoint of the primary care pediatrician, however, perhaps the most important initial classification is the differentiation between genetic and acquired causes. Within each of these categories, there are a host of possible diagnoses. In this issue of The Journal, Benini et al report the analysis of a large series of children (n = 167) from the Montreal Children's Hospital and an outpatient neurology clinic, all of whom were initially seen for symptoms of ataxia. Nearly 90% of these children were ultimately diagnosed with acquired ataxia. The small group with genetic causes was much more likely to display gait disturbance, muscle weakness, and abnormal tone, and was more likely to have a family history and evidence of consanguinity. For most children being seen with ataxia, the initial diagnostic approach will likely be more productive if it focuses on acquired conditions, unless the features noted by Benini et al suggest otherwise. Article page 152▶ Clinical Clues to Differentiating Inherited and Noninherited Etiologies of Childhood AtaxiasThe Journal of PediatricsVol. 160Issue 1PreviewTo identify clinical features at presentation that differentiate inherited and noninherited etiologies of childhood ataxias. Full-Text PDF