• Tiffany Rudloe, Sanjay P Prabhu, Mark P Gorman, Lise E Nigrovic, Marvin B Harper, Assaf Landschaft, and Amir A Kimia.
• Division of Emergency Medicine, Department of Medicine, Children's Hospital Boston, Boston, MA, USA.
• J. Child Neurol. 2015 Sep 1; 30 (10): 1333-9.

AbstractTo determine the yield of neuroimaging in children presenting to the emergency department with acute ataxia in the post-varicella vaccine era, we conducted a cross-sectional study between 1995 and 2013 at a single pediatric tertiary care center. We included children aged 1-18 years evaluated for acute ataxia of <7 days' duration. The main outcome was clinically urgent intracranial pathology defined as a radiologic finding that changed initial management. We identified 364 children, among whom neuroimaging was obtained in 284 (78%). Forty-two children had clinically urgent intracranial pathology (13%, 95% confidence interval 9%-17%); tumors and acute disseminated encephalomyelitis were the leading findings. Age ≤3 years and symptoms ≤3 days of duration were predictors of low risk (0.7%, 95% confidence interval 0%-4.4%). In conclusion, neuroimaging may be indicated for most patients presenting with acute ataxia. Neuroimaging may be deferred in younger children with short duration of symptoms contingent on close follow-up. © The Author(s) 2014.

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