Paediatric infections: post-varicella cerebellar ataxia: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric infections: post-varicella cerebellar ataxia

Sample item

A 5-year-old develops unsteady gait, truncal ataxia and intention tremor 8 days after the rash of chickenpox. He is alert, afebrile and has no signs of raised intracranial pressure; CSF shows a few lymphocytes with normal glucose. What is the best management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Supportive care, as it is usually self-limited

Acute cerebellar ataxia is the commonest neurological complication of varicella and appears in the first 2 to 3 weeks. It is thought to be post-infectious, and recovery over days to weeks is the rule. Surgery or immunotherapy is not needed in a child with a benign course.

Option by option

  • A. Supportive care, as it is usually self-limited (correct)

    Correct. Acute post-varicella cerebellar ataxia generally resolves spontaneously with support.

  • B. Urgent posterior fossa surgery

    There is no mass or hydrocephalus to require surgery.

  • C. Pulse intravenous methylprednisolone

    Steroid pulses are not required for this self-limited illness.

  • D. Plasmapheresis

    Plasmapheresis is reserved for severe immune-mediated neurological disease.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is A, Supportive care, as it is usually self-limited. Acute cerebellar ataxia is the commonest neurological complication of varicella and appears in the first 2 to 3 weeks.

Why is "Urgent posterior fossa surgery" not the answer?

There is no mass or hydrocephalus to require surgery.

Why is "Pulse intravenous methylprednisolone" not the answer?

Steroid pulses are not required for this self-limited illness.

Why is "Plasmapheresis" not the answer?

Plasmapheresis is reserved for severe immune-mediated neurological disease.

What concept does this question test?

It tests Paediatric infections: post-varicella cerebellar ataxia in Pediatrics. It is thought to be post-infectious, and recovery over days to weeks is the rule. Surgery or immunotherapy is not needed in a child with a benign course.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric infections: post-varicella cerebellar ataxia?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.