Ataxia in Childhood

SUMMARY The object of this paper has been to attempt to classify certain cases of ataxia occurring in children which do not fall under well‐known types of diseases. The cases have been regarded from their clinical rather than their pathological aspect, and from their clinical features it would seem probable that the symptoms are due to lesions of the cerebellum and cerebellar peduncles. This is to some extent borne out by the pathological evidence of reported cases, but there is at the same time considerable evidence pointing to affection of tracts and portions of the nervous system other than the cerebellum. The cases group themselves into three main divisions:1 Cases in which ataxia has been noticed from earliest life, and in which there is a tendency to gradual improvement (congenital cerebellar ataxia). 2 Cases in which ataxia has suddenly developed during the course of or after some acute illness in a child who was formerly quite healthy (acute ataxia, encephalitis cerebelli). 3 Cases in which ataxia has gradually developed in a child who has been healthy and of normal development until the onset of the disease (progressive cerebellar ataxia).Instances of these various types are given, and it is pointed out that whereas in cases belonging to groups 1 and 2 the prognosis is relatively good, in the cases belonging to group 3 the prognosis is bad. The pathology of the disease is discussed, and it is shown from the record of the published cases that changes in the cerebellum are the most constant feature in this affection, though such changes are frequently accompanied by other lesions of or lack of development in the cerebrum, pons, medulla or spinal cord. Further research is needed to establish the above clinical classification on a pathological basis. A general bibliography will be found in references (5), (18), (19), (23).