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Ataxia.
[pyruvate dehydrogenase deficiency]
The
approach
to
the
child
with
ataxia
requires
a
detailed
history
and
careful
general
and
neurological
examination
as
well
as
selected
blood
work
and
brain
imaging
and
increasingly
available
genetic
testing
for
inherited
ataxias
that
usually
have
an
episodic
or
progressive
presentation
.
The
differential
of
acute
and
recurring
ataxia
covered
in
this
chapter
includes
intoxication
(
e
.
g
.
,
antiepileptics
,
lead
,
alcohol
)
,
postinfectious
cerebellitis
,
hemorrhage
,
ischemic
stroke
,
tumor
(
posterior
fossa
or
cerebellum
)
,
brainstem
encephalitis
,
occult
neuroblastoma
,
Miller
Fisher
syndrome
,
conversion
reaction
,
multiple
sclerosis
,
epileptic
pseudoataxia
,
vasculitis
(
e
.
g
.
,
Kawasaki
)
,
metabolic
etiologies
(
e
.
g
.
,
maple
syrup
urine
disease
,
pyruvate
dehydrogenase
deficiency
,
ornithine
transcarbamylase
deficiency
,
biotinidase
deficiency
,
Hartnup
disease
,
and
argininosuccinic
aciduria
)
,
migraine
,
migraine
equivalents
(
benign
paroxysmal
positional
vertigo
)
,
autosomal
dominant
episodic
ataxias
(
with
seven
types
currently
identified
)
,
and
hypothyroidism
.
Cooperation
with
therapists
and
providers
from
other
specialties
including
ophthalmology
and
genetics
and
metabolism
is
essential
to
caring
for
these
children
and
their
families
.
Diseases
Validation
Diseases presenting
"increasingly available genetic testing for inherited ataxias that usually have an episodic or progressive presentation"
symptom
pyruvate dehydrogenase deficiency
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