Neurocritical Care

, Volume 31, Issue 3, pp 559–561 | Cite as

Cerebellitis with Mass Effect: A-Not-So-Everyday Problem for the Neurointensivist

  • Lauren Jackson
  • Edison Cano Cevallos
  • Eelco WijdicksEmail author
Practical Pearl

Case Presentation

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...


Cerebellitis Ataxia Edema Hydrocephalus 


Author’s Contributions

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

Informed consent was obtained from the patient.

Supplementary material

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)


  1. 1.
    Samkar AV, Poulsen MNF, Bienfait HP, Van Leeuwen RB. Acute cerebellitis in adults: a case report and review of the literature. BMC Res Notes. 2017;10:610.CrossRefGoogle Scholar
  2. 2.
    Lee S, Le S. A new association between Castleman disease and immune-mediated cerebellitis. JAMA Neurol. 2015;72:722–3.CrossRefGoogle Scholar
  3. 3.
    Vreuggdenhil GR, Batstra MR, Aanstoot HJ, Melchers WJ, Galama JM. Analysis of antibody responses against coxsackie virus B4 protein 2C and the diabetes autoantigen GAD(65). J Med Virol. 1999;59(2):256–61.CrossRefGoogle Scholar
  4. 4.
    Sawaishi Y, Takada G. Acute cerebellitis. Cerebellum. 2002;1:223.CrossRefGoogle Scholar
  5. 5.
    Marignier R, Chenevier F, Rogemond V, Sillevis Smitt P, Renoux C, Cavillon G, Androdias G, Vukusic S, Graus F, Honnorat J, et al. Metabotropic glutamate receptor type 1 autoantibody-associated cerebellitis: a primary autoimmune disease? Arch Neurol. 2010;67:627–30.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature and Neurocritical Care Society 2019

Authors and Affiliations

  1. 1.Department of NeurologyMayo ClinicRochesterUSA
  2. 2.Department of Infectious DiseasesMayo ClinicRochesterUSA

Personalised recommendations