Pediatric Fulminant Cerebellitis Is Still a Fatal Disease that We Know Little About! Two Case Reports and a Literature Review

Hakem Alomani; Muhammad Arshad; Mahmoud Elzonfly; Ali Ahmad Aldakhil; Abdullah H. Alharbi; Abdulrahman Alasqah; Bandar Rashed Alfheed; Hesham Aldhalan

doi:10.12659/AJCR.928370

17 January 2021 : Case report Saudi Arabia

Pediatric Fulminant Cerebellitis Is Still a Fatal Disease that We Know Little About! Two Case Reports and a Literature Review

Unusual clinical course, Challenging differential diagnosis, Rare disease

Hakem Alomani^1ADEF*, Muhammad Arshad^2EF, Mahmoud Elzonfly^2B, Ali Ahmad Aldakhil^2B, Abdullah H. Alharbi^3BD, Abdulrahman Alasqah^4BE, Bandar Rashed Alfheed^5CD, Hesham Aldhalan^6AEF

DOI: 10.12659/AJCR.928370

Am J Case Rep 2021; 22:e928370

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Table 1. Summary and findings of case reports in the literature review of fulminant cerebellitis (total 11 cases).

Author	Country	Publication year	Age in yrs	Gender	Presenting symptoms	Neurological findings	CSF study
Wege L. et al.	Poland	2010	4	Boy	Headache VomitingGait disorderNo fever	Ataxia	Unremarkable
De Mendoca J. et al.	Brazil	2005	11	Girl	HeadacheVomitingNo Fever	Normal	Not done
De Mendoca J. et al.	Brazil	2005	9	Boy	HeadacheVomitingNo Fever	Neck stiffness	Not done
Kamat M. et al.	India	2009	9	Boy	HeadacheVomitingGait disorder fever	AtaxiaBilateral RectalPalsyPapilledema	Unremarkable
Elad L. et al.	USA	2001	13	Girl	HeadacheGait disorder	Fixed dilated pupils	Unremarkable
De Ribaupierre S. et al.	Switzerland	2005	6	Girl	Headache Vomiting Photophobia	Normal	Unremarkable
Kornreich L. et al.	Israel	2016	3	Girl	FeverAbnormal gaitSlow speech	Decrease tone in Rt upper and lower limbs	Unremarkable
Kornreich L. et al.	Israel	2016	5	Boy	Abnormal gaitVomiting	Ataxia	Unremarkable
Kornreich L. et al.	Israel	2016	7	Girl	HeadacheVomiting	AtaxiaTorticollis	Unremarkable
Kornreich L. et al.	Israel	2016	9	Boy	HeadacheVomitingPhotophobia	normal	Positive for HSV (serology)
De Ribaupierre S. et al.	Switzerland	2005	14	Girl	Headache photophobia nausea	Normal	Unremarkable
Author	Brain image finding	Medical intervention	Surgical intervention	Outcome	Remarks
Wege L. et al.	CT: Dilated supratentorial ventricular system.Swelling of both cerebellar hemispheres.Cerebellar tonsillar herniation	IVIGOthers: Not clear	Decompressive craniotomy	SurvivedNo neurological deficit
De Mendoca J. et al.	MRI: Swelling of Rt cerebellar hemisphere.Compressed 4 ventricleNO hydrocephalus	Antibiotic antiviral	None	SurvivedNo neurological deficit	Unilateral cerebellitis
De Mendoca J. et al.	MRI: Swelling of Rt cerebellar hemisphere.Compressed 4 ventricleNO hydrocephalus	Antibiotic antiviral	None	SurvivedNo neurological deficit	Unilateral cerebellitis
Kamat M. et al.	MRI: 4 ventricle obstruction.Hydrocephalus.Swelling of both cerebellar hemispheres	steroid	VP shunt	Died	Family refusedDecompressivecraniotomy
Elad L. et al.	CT: Hydrocephalus with 4 ventricle obstruction. Diffused swelling of both cerebellar hemispheres	Mannitol steroid	VP shunt	Died
De Ribaupierre S. et al.	CT: showed posterior fossa meningeal enhancement and diffuse cerebellar swelling, with a slight upward trans-tentorial and downward trans-foramen magnum herniation	Dexamethasone	VP shuntDecompressive craniotomyResection of cerebellar tonsils	SurvivedNo neurological deficit	Follow-up period: 19 months
Kornreich L. et al.	MRI: Swelling of Rt cerebellar hemisphere	Steroid acyclovir	None	Survived With neurological deficit (Right hand tremor, mildmotor clumsiness, mild speech delay)	Follow-up period: 156 months
Kornreich L. et al.	MRI: Diffuse Swelling, cerebellar hemispheres.Tonsillar herniation	SteroidDoxycyclineAcyclovir	None	SurvivedWith neurological deficit. (Ataxia, dysarthria)	Follow-up period: 7 months
Kornreich L. et al.	MRI: Swelling of both cerebellar hemispheres.Mild Tonsillar herniation	SteroidMannitolAcyclovirAzithromycin	None	SurvivedWith NO neurological deficit	Follow-up period: 2 months
Kornreich L. et al.	MRI: Diffused swelling of both cerebellar hemispheres. mild Tonsillar herniation	SteroidMannitolAcyclovirDoxycycline	VP shunt	SurvivedWith NO neurological deficit	Follow-up period: 34 months
De Ribaupierre S. et al.	CT: showed fullness of the posterior fossa, slight upward trans-tentorial and downward transforamen magnum herniation and hydrocephalusMRI showed bilateral cerebellar hemisphere hyperintensities on fluid-attenuated conversion recovery (FLAIR) sequences	Dexamethasone	VP shuntDecompressive craniotomyResection of cerebellar tonsils	SurvivedNo neurological deficit	Follow-up period: 13 months

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Pediatric Fulminant Cerebellitis Is Still a Fatal Disease that We Know Little About! Two Case Reports and a Literature Review

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