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Neurological Rehabilitation

Cerebellitis in Sjogren's Syndrome: A Case Report

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 5

    Poster Presenter(s)

  • Eva Amram, MD (she/her/hers)

    Resident
    MedStar Washington Hospital Center/Spaulding Rehabilitation
    Washington, District of Columbia

    • Co-Author(s)

  • AG

    Ashley Gureck, MD

    Resident Physician
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Boston, Massachusetts

  • JD

    John Danko, DO

    Associate Chief Medical Officer
    Spaulding Rehabilitation Hospital
    Arlington, Massachusetts

Disclosure(s):
Eva Amram, MD: No financial relationships to disclose
Case Diagnosis: Our patient was a previously healthy 35-year-old female with immune-mediated cerebellitis attributed to Sjogren’s Syndrome (SS).

Case Description or Program Description: The patient presented to our IRF following 2 months of progressive dysarthria, dysphonia, diffuse ataxia, and multidirectional nystagmus. Brain and spine imaging was unremarkable. She received an initial diagnosis of functional neurologic disorder. Serum results were later positive for ANA, anti-RNP, anti-SSB/Ro, and anti-SSA/La. A presumptive diagnosis was made of autoimmune cerebellitis. She received IV methylprednisolone and IVIG in acute care with improvements in gaze, and was discharged to IRF on oral prednisone taper. Functional deficits on admission included ataxia, impaired vision, dysarthria, dysphagia, weakness, impaired gait, impaired sequencing, impaired verbal fluency, and neurogenic bowel and bladder. Barriers to therapy in rehab included dizziness, vomiting, abdominal pain due to ileus, and mood. Meclizine was initiated and later discontinued to aid in habituation of central-mediated dizziness, and symptoms improved somewhat with vestibular therapy. Psychology was consulted for cognitive-affective symptoms. Adaptive equipment included weighted utensils and ankle weights for ataxia, and a thoracic walker for retropulsive gait.

Setting: Inpatient rehabilitation facility (IRF)

Assessment/Results: The patient was discharged to home with services after 2 weeks. She continued to require assistance with ADLs, mobility, speaking, and swallowing.
She later underwent a PET scan that demonstrated diffuse hypoperfusion of the cerebellum.

Discussion (relevance): Imaging-negative autoimmune cerebellitis is a rare diagnosis, with less than 10 reported cases of cerebellitis in SS. Early diagnosis, treatment, and rehabilitation could aid in improved functional outcomes.

Conclusions: Multidisciplinary rehabilitation consisting of physical, occupational, speech, and cognitive therapies should aim to address functional and psychological deficits of diffuse cerebellar dysfunction. A prolonged course may be warranted depending on severity of deficits.