title: Recurrent Ataxia in Children and Adolescents.
abstract: BACKGROUND
  Recurrent ataxia is encountered infrequently in clinical pediatric neurology practise and presents with diagnostic challenges. It is caused by several disorders. Our aims were to describe the epidemiology and clinical features in children with recurrent ataxia.
  
  
  METHODS
  A retrospective review was undertaken in 185 children with chronic ataxia, who presented during 1991 to 2008. Several databases were searched to ensure optimum ascertainment. Patients with brain tumors or isolated disorders of the peripheral nerves or vestibular system were excluded.
  
  
  RESULTS
  Recurrent ataxia was reported in 21 patients. Their age range was between 6 and 32.75 years (males=12). The crude period prevalence rate for the 18-year study period was 7.44/100,000. Eight patients had episodic ataxia and seven had inflammatory and metabolic disorders. In the rest the etiology was unknown. Many patients presented with ataxia, dizziness, and vertigo. The frequency and duration of the ataxic episodes varied from several per day to one every few months. Other clinical features included developmental delay and seizures. Neuroimaging in episodic ataxia was normal and abnormal in inflammatory or metabolic disorders. Acetazolamide provided symptomatic relief in patients with episodic ataxia, while steroids were beneficial in patients with an inflammatory etiology. One child with a metabolic disorder died.
  
  
  CONCLUSIONS
  Recurrent ataxia is an uncommon presentation in children and mortality is rare. Genetic, metabolic, and inflammatory disorders should be considered in these patients. Neuroimaging is essential. Acetazolamide in selected patients provides good symptomatic relief.
authors.affiliation: 1Section of Pediatric Neurology,Winnipeg Children's Hospital and Department of Pediatrics and Child Health,University of Manitoba,Winnipeg,Manitoba,Canada.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Salman
authors.affiliation: 3Max Rady College of Medicine, Faculty of Health Sciences,University of Manitoba,Winnipeg,Manitoba,Canada.
authors.forename: Samantha F
authors.initials: SF
authors.lastname: Klassen
authors.affiliation: 2Section of Neurology,Departments of Medicine and Ophthalmology,University of Manitoba,Winnipeg,Manitoba,Canada.
authors.forename: Janine L
authors.initials: JL
authors.lastname: Johnston
mesh_terms: D000293:Adolescent; D000328:Adult; D001259:Ataxia / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D016208:Databases, Factual / Q000706:statistics & numerical data; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D059906:Neuroimaging; D015995:Prevalence; D012008:Recurrence; D012189:Retrospective Studies; D055815:Young Adult
keywords: Recurrent ataxia; episodic ataxia; intermittent ataxia; pediatrics