IntroductionPostinfectious acute cerebellar syndromes show a wide spectrum of acute severity and can occur with acute febrile illness or vaccine receipt. Varicella has historically been the most common cause, associated with up to 25% of cases in large cohorts. This study aimed to describe the spectrum of syndromes in a setting with high varicella vaccine coverage.MethodData were collected on children initially identified as “suspected encephalitis” subsequently designated “not-encephalitis” at participating children's hospitals in the Paediatric Active Enhanced Disease Surveillance (PAEDS) network, Australia, as part of the Acute Childhood Encephalitis study. A comprehensive descriptive analysis was undertaken on prospectively identified, national series of children with postinfectious acute cerebellar syndromes from 2013 to 2018. Cases were classified using a previously validated severity score, and the outcome was assessed at 12 months using the Liverpool Outcome Scale score.ResultsA total of 20 cases (65% were vaccinated for varicella) were included, of which 70% were subcategorized as acute cerebellar ataxia (ACA), 20% acute cerebellitis (AC), and 10% acute fulminant cerebellitis (AFC). An acute febrile illness was noted in 55% and none were related to varicella or were temporally related to varicella vaccination or other childhood vaccines. A subset (total of 7 children) followed up at 12 months all showed reduced Liverpool Outcome Scale scores.DiscussionThe study provides an overall description of this uncommon spectrum of neurologic syndromes and shows the infrequency of varicella zoster virus as a cause in a vaccinated population.

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儿童感染后急性小脑综合征：2013-2018 年澳大利亚全国确诊病例系列

简介感染后急性小脑综合征表现出广泛的急性严重程度，并且可能发生在急性发热性疾病或接种疫苗时。水痘历来是最常见的原因，与大型队列中高达 25% 的病例相关。本研究旨在描述水痘疫苗覆盖率高的情况下的综合征谱。方法数据收集了最初被确定为“疑似脑炎”的儿童，随后在参与的儿童医院儿科主动增强疾病监测 (PAEDS) 中被指定为“非脑炎” ) 网络，澳大利亚，作为急性儿童脑炎研究的一部分。对 2013 年至 2018 年前瞻性确定的全国感染后急性小脑综合征儿童系列进行了全面的描述性分析。使用先前验证的严重程度评分对病例进行分类，并使用利物浦结果量表评分在 12 个月时评估结果。 结果共纳入 20 例（65% 接种了水痘疫苗），其中 70% 被分类为急性小脑共济失调 (ACA)、20% 的急性小脑炎 (AC) 和 10% 的急性暴发性小脑炎 (AFC)。55% 的人出现急性发热性疾病，没有一个与水痘相关，或与水痘疫苗接种或其他儿童疫苗暂时相关。在 12 个月时随访的一个子集（共 7 名儿童）均显示利物浦结局量表评分降低。讨论该研究提供了对这种不常见的神经系统综合征谱的总体描述，并显示水痘带状疱疹病毒在接种人群中的频率不高。