Cerebellitis with Mass Effect: A-Not-So-Everyday Problem for the Neurointensivist
A 25-year-old woman had otherwise been in normal health until approximately 1 week earlier, when she presented to her primary care provider with a 2-day history of painful mouth ulcers, sore throat, and watery diarrhea. She denied any fever or upper respiratory symptoms, such as cough or rhinorrhea, at that time. She denied any other rashes. She had reported that her nephew had been diagnosed with hand–foot–mouth disease earlier that month; otherwise, she denied any sick contacts. She was treated conservatively by her physician.
Approximately 7 days after initial symptoms, she developed an acute progressive holocephalic headache, accompanied by nausea and vomiting, and progressed to full-body myalgias. She presented to the emergency department several times for the above symptoms and ultimately underwent a computed tomography (CT) scan without contrast of the brain, which was negative for any abnormalities. Her headache persisted, and she was admitted to the outside...
KeywordsCerebellitis Ataxia Edema Hydrocephalus
LJ was involved in study concept and design, acquisition of data, analysis and interpretation, and drafting of the manuscript. ECC was involved in analysis and interpretation and drafting of the manuscript. EW was involved in study concept and design, analysis and interpretation, and critical revision of the manuscript for important intellectual content.
Source of Support
No source of support was used to fund this report.
Conflicts of Interest
All authors declare that they have no conflicts of interest.
Informed consent was obtained from the patient.
Video I Her examination was notable for saccadic eye movements, left sixth nerve palsy, ataxic dysarthria, overshoot on Holmes rebound testing, and intention tremor noted with finger to nose testing and heel to opposite shin testing. (MP4 36249 kb)