Neuropediatrics 2004; 35(6): 368-370
DOI: 10.1055/s-2004-830370
Short Communication

Georg Thieme Verlag KG Stuttgart · New York

Frontal Ataxia in Childhood

C. E. Erasmus1 , T. Beems2 , J. J. Rotteveel1
  • 1Department of Paediatric Neurology, University Medical Centre St. Radboud, Nijmegen, The Netherlands
  • 2Department of Neurosurgery, University Medical Centre St. Radboud, Nijmegen, The Netherlands
Further Information

Publication History

Received: May 2, 2004

Accepted after Revision: September 12, 2004

Publication Date:
15 November 2004 (eFirst)

Abstract

Frontal ataxia may be the result of a unilateral frontal lesion. In this report three cases are presented with ataxia due to right frontal lesions. One case concerns a boy presenting with an unsteady gait and titubation of the trunk, mimicking developmental disequilibrium and with complex partial seizures. It proved to be caused by a small right-sided cavernoma in the middle frontal gyrus. After surgical intervention the symptoms and the seizures disappeared. Two subsequent cases concern teenage patients presenting with headache after an ENT infection and on physical examination mild dysmetric function of the upper limbs and slight disequilibrium, due to right-sided frontal lobe abscesses. After neurosurgical and antibiotic therapy the symptoms were relieved. The frontal origin of ataxia should be considered in children presenting with a “cerebellar syndrome”. Frontal gait disorders consist of a clinical pattern of different gait disorders. The syndrome has been mentioned in the literature under different names. Our patients show signs compatible with the term frontal disequilibrium, a clinical pattern of frontal gait disorder. This assumes walking problems characterized by loss of control of motor planning, leading to imbalance. Remarkably, frontal ataxia may mimic developmental delay as demonstrated in the first case and may be the leading mild symptom in extensive frontal lobe damage as demonstrated by the two other cases. We suppose that frontal ataxia is the result of a disturbance in the cerebellar-frontal circuitries and an impairment of executive and planning functions of the basal ganglia-frontal lobe circuitry.

References

MD C. E. Erasmus

Department of Child Neurology
University Medical Centre St. Radboud

PO Box 9101

6500 HB Nijmegen

The Netherlands

Email: c.erasmus@cukz.umcn.nl