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Journal of Pediatric Neurology 2022; 20(03): 211-214
DOI: 10.1055/s-0041-1731029
Case Report

A Case of Influenza Virus-Induced Acute Cerebellitis Treated with Steroid Pulse Therapy

Yukiho Hirota
1   Department of General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
,
Shogo Minamikawa 
1   Department of General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
2   Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan
,
Yusuke Ishida
1   Department of General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
,
Azusa Maruyama
3   Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
,
Yasuo Nakagishi
1   Department of General Pediatrics, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan
› Author Affiliations Funding This work was supported by JSPS KAKENHI (grant number JP20K16856) to S.M.
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Abstract

Acute cerebellitis (AC) is characterized by acute onset cerebellar ataxia brain magnetic resonance imaging (MRI) abnormalities of the cerebellum. The most common cause of AC is viral infection, and some patients with AC experience neurological sequelae. AC associated with influenza virus is extremely rare, and its prognosis and treatment are unknown. We present the case of a 2-year-old boy with influenza virus-induced AC who was treated with pulse steroid therapy. The patient presented with fever, anorexia, vomiting, malaise, altered consciousness, truncal ataxia, dysmetria, and dysarthria. He was diagnosed with influenza using a nasopharyngeal antigen test. Brain MRI showed hyperintense T2 and diffusion-weighted signal abnormalities in the cerebellar white matter and dentate nuclei bilaterally. The patient was treated with two courses of pulse methylprednisolone therapy and recovered completely in 2 months after the onset. The prognosis of AC is poorer than that of acute cerebellar ataxia, which shows similar symptoms to AC with normal brain MRI. The type of virus might also be associated with the prognosis of AC. Literature review showed that one of the five cases (including the present case, 20%) reported with influenza-associated AC was noted to have neurological sequelae, which might be more severe than those of varicella-zoster-related AC. Given that the pathogenesis of AC is assumed to be immune-mediated, pulse methylprednisolone therapy might be a good option for the treatment of influenza virus-induced AC.

Keywords

acute cerebellitis - influenza virus - steroid pulse - acute cerebellar ataxia


Publication History

Received: 08 January 2021

Accepted: 15 April 2021

Article published online:
26 June 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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