Tc-99m HMPAO brain SPECT Imaging in children with acute cerebellar ataxia

PURPOSE: We prospectively evaluated consecutive cases of acute cerebellar ataxia in children to identify brain perfusion SPECT features associated with acute cerebellar ataxia and to correlate the brain SPECT findings to clinical severity and prognosis. RESULTS: Among the 10 consecutive children with acute cerebellar ataxia, 7 had abnormal Tc-99m HMPAO brain SPECT findings (4 cerebellar hypoperfusion, 5 unilateral cortical and/or subcortical hypoperfusion, and 1 unilateral cortical hyperperfusion), in contrast to no abnormalities disclosed by CT or MR imagings. Furthermore, the extent of brain perfusion SPECT abnormalities correlated significantly with the clinical severity and the recovery time of cerebellar ataxia. Sixty percent of children with acute cerebellar ataxia had cortical and/or subcortical involvement, which implied the wider involvement of acute cerebellar ataxia than what has been thought. CONCLUSION: The present data suggest that Tc-99m HMPAO brain SPECT is a sensitive modality for providing prognostic information in childhood acute cerebellar ataxia.