Abstract
This review summarizes the history, classification, and pathophysiology of immune-mediated cerebellar ataxias (IMCA), including gluten ataxia, post-infectious cerebellitis (PIC), opsoclonus-myoclonus syndrome (OMS), paraneoplastic cerebellar degeneration (PCD), anti-GAD ataxia, and primary autoimmune cerebellar ataxia (PACA). The cerebellum retains notable capacity for compensation and recovery after injury, making early immunotherapy — before an irreversible "threshold" is crossed — critical for prognosis. Specific antibodies (anti-Yo, Hu, CV2, Ri, Ma2, GAD65) help identify underlying etiologies. Treatment involves removing the triggering factor (gluten-free diet, tumor resection) combined with immunotherapy (IVIG, corticosteroids, plasma exchange, rituximab). Acetyl-DL-leucine is discussed as an adjunctive therapy for ataxic symptoms.
