TABLE 15.2 DIFFERENTIAL DIAGNOSIS OF ACUTE OR RECURRENT ATAXIA, INCLUDING LESS COMMON CAUSES Infectious and immune mediated Acute cerebellitis Acute disseminated encephalomyelitis (ADEM) Multiple sclerosis exacerbation Tick paralysis a Meningitis Benign peripheral Benign paroxysmal vertigo a Labyrinthitis a Cerebrovascular Ischemic or hemorrhagic posterior circulation stroke Cerebral sinovenous thrombosis Vasculitis Headache related Migraine Postconcussion syndrome Conversion disorder Genetic/metabolic diseases Hartnup disease Wilson disease Maple syrup urine disease Pyruvate decarboxylase deficiency Episodic ataxia type (paroxysmal ataxia and myokymia) Episodic ataxia type (acetazolamide-responsive ataxia) Posterior fossa pathology Acute hydrocephalus Posterior fossa tumors a Indicates weakness or vertigo that may mimic ataxia