Postinfectious cerebellitis in a preadolescent child

Varicella is a common, typically self-limiting, viral illness that often occurs in childhood. However, neurological complications, such as encephalitis, vasculopathy and cerebellitis, can occur. Postinfectious cerebellitis is presumed to be immune-mediated, typically presenting within days to weeks of rash onset. Diagnosis is primarily clinical, as early neuroimaging and cerebrospinal fluid (CSF) analysis may be normal. Treatment is usually supportive, though corticosteroids or antivirals may be used in severe or atypical cases.We report a case of postinfectious cerebellitis in a preadolescent male, presenting 1 week after the resolution of varicella rash. Symptoms included ataxia, dysarthria, dysdiadochokinesia and hypertonia. Despite classic cerebellar signs, imaging and CSF analysis were unremarkable. Clinical improvement followed a short course of empirical treatment for suspected meningoencephalitis; however, residual neurological deficits persisted, necessitating physiotherapy.This case highlights the potential for significant neurological involvement in postinfectious cerebellitis despite normal investigations, underscoring the need for clinical vigilance, timely intervention and multidisciplinary follow-up.