This case provided an excellent example of how the initial working diagnosis can change over time as further clinical, radiological and haematological information is obtained from specialised investigations. It also illustrates that association is not always causation i.e. the head injury coincides with symptom onset, yet there was no evidence of cerebellar injury on imaging. The complex nature of each individual’s health can be seen in this young patient. Rarely does a health problem present according to the “textbook” definition, nor do problems exist in isolation. Many patients present with one issue but have an underlying condition, such as anaemia, unearthed during investigations. Acute Ataxia This patient’s likely diagnosis is acute ataxia, a relatively uncommon condition with an incidence of 1 in 100,000. Acute ataxia is the sudden loss of voluntary, coordinated muscle …show more content…
Acute cerebellar ataxia in children is a self-limiting disorder which typically resolves within 5 to 12 days. The outcome of the condition is determined predominantly by aetiology. 90% of children recover without any neurologic sequelae with 10% having some long-term neurological problems. Current recommendations state that a child does not require hospitalisation provided all serious causes of acute cerebellar ataxia have been ruled out. Conservative management is the preferred treatment. All children need clinical re-evaluation 2 weeks following the initial presentation of symptoms. If the child’s symptoms persist, worsen, or if new symptoms appear during this time, investigations for other causes of ataxia are necessary. Diet and Anaemia in Children During the investigations of the patient’s ataxia, it was discovered that Master A.B. had a hypochromic, microcytic anaemic. • Haemoglobin → 6.8 g/dL, • Mean Corpuscular Volume → 76.8 fL, • Mean Corpuscular Haemoglobin → 22.5