Acute cerebellar ataxia due to Sjogren syndrome

Abstract

Acute cerebellar ataxia is more common in pediatric patients than in adults and is usually caused by a postinfectious process or drug ingestion. Although a myriad of other causes have been described, acute cerebellar ataxia has not been reported as the presenting symptom of Sjogren syndrome. We report a previously healthy adolescent girl who was examined for acute cerebellar ataxia and MRI findings of parotitis and who was diagnosed with primary Sjogren syndrome (PSS). A girl aged 16 years developed a headache; evaluation at a local emergency department with head CT revealed sinusitis, and she was treated with antibiotics. A few days later, she developed leg numbness, dysarthria, and ataxia. An MRI at another hospital demonstrated “cerebellar inflammation,” and a lumbar puncture revealed a protein of 110 and leukocyte count of 210 with a lymphocytic pleocytosis. Treatment with cefotaxime and acyclovir was stopped after CSF cultures, herpes simplex virus PCR, and blood cultures were negative. After discharge, her primary doctor …