[Cerebellar atrophy following acute Mycoplasma pneumoniae cerebellitis]. / Atrofia cerebelosa secundaria a cerebelitis aguda por Mycoplasma pneumoniae.

INTRODUCTION: Acute cerebellitis is an uncommon complication following Mycoplasma pneumoniae infection. A benign and self-limited course has been described in the few reports found of this association. CASE REPORTS: We report two patients with an apparently M. pneumoniae-induced acute cerebellitis that resulted in cerebellar atrophy. Patients presented with a cerebellar syndrome including ataxia, hypotonia, dysarthric speech and dysmetria, which were preceded by signs of respiratory infection. Initial brain magnetic resonance imaging (MRI) in case 1 was normal but in case 2 it displayed striking cerebellar swelling, small fourth ventricle and supratentorial ventriculomegaly which was self-limited and did not require neurosurgical intervention. Serological studies confirmed a recent M. pneumoniae infection. Case 1 has followed an unfavourable clinical course, with incomplete resolution of cerebellar dysfunction, while case 2 has remained asymptomatic. Follow-up brain MRI have demonstrated prominent cerebellar atrophy in both patients. CONCLUSIONS: M. pneumoniae infection should be considered in those patients with acute cerebellitis showing an incomplete resolution of cerebellar dysfunction or those who develop early cerebellar atrophy. The presenting MRI findings do not seem to predict final neurological outcome.

Atrofia cerebelosa secundaria a cerebelitis aguda por Mycoplasma pneumoniae / Cerebellar atrophy following acute mycoplasma pneumoniae cerebellitis

Introducción. La cerebelitis aguda es una complicación infrecuente de la infección por Mycoplasma pneumoniae. Los pocos pacientes descritos han seguido un curso benigno y autolimitado de forma similar al de las cerebelitis relacionadas con otros gérmenes. Casos clínicos. Describimos dos pacientes con una cerebelitisaguda por M. pneumoniae que evoluciona en pocos meses hacia una marcada atrofia cerebelosa. Los pacientes presentaron un síndrome cerebeloso caracterizado por ataxia, hipotonía, disartria y dismetría de las cuatro extremidades, precedido por signos de infección respiratoria. La resonancia magnética (RM) cerebral practicada durante la fase aguda en el caso 1 resultó normal y e nel caso 2 demostró un llamativo edema del parénquima cerebeloso, con IV ventrículo pequeño y ventriculomegalia supratentorial, que se autolimitó y que no requirió de intervención neuroquirúrgica. Los estudios serológicos permitieron confirmar la infección reciente por M. pneumoniae. En el caso 1 se ha observado la persistencia de signos de disfunción cerebelosa, mientras que el caso 2 está asintomático. Ambos pacientes muestran una llamativa atrofia cerebelosa en las RM cerebrales practicadas a lo largo de su control clínico. Conclusiones. Debe considerarse la infección por M. pneumoniae en pacientes con cerebelitis aguda que presenten resolución incompleta de la disfunción cerebelosa o que evolucionen de forma precoz hacia la atrofia cerebelosa. Las manifestaciones neurorradiológicas iniciales no permiten predecir el pronóstico neurológico final (AU)

Introduction. Acute cerebellitis is an uncommon complication following Mycoplasma pneumoniae infection. A benign and self-limited course has been described in the few reports found of this association. Case reports. We report twopatients with an apparently M. pneumoniae-induced acute cerebellitis that resulted in cerebellar atrophy. Patients presented with a cerebellar syndrome including ataxia, hypotonia, dysarthric speech and dysmetria, which were preceded by signs of respiratory infection. Initial brain magnetic resonance imaging (MRI) in case 1 was normal but in case 2 it displayed striking cerebellar swelling, small fourth ventricle and supratentorial ventriculomegaly which was self-limited and did not requiren euro surgical intervention. Serological studies confirmed a recent M. pneumoniae infection. Case 1 has followed an unfavourable clinical course, with incomplete resolution of cerebellar dysfunction, while case 2 has remained asymptomatic. Follow-up brain MRI have demonstrated prominent cerebellar atrophy in both patients. Conclusions. M. pneumoniae infection should be considered in those patients with acute cerebellitis showing an incomplete resolution of cerebellar dysfunction or those who develop early cerebellar atrophy. The presenting MRI findings do not seem to predict final neurological outcome (AU)