Acute cerebellitis is a rare condition caused predominantly by viral infections. Seen in children and young adults, cases of acute cerebellitis associated with the influenza virus (and its vaccination) have been sparsely characterised in the literature. We report here a case of a teenage girl (previously fit and well) who presented with features of fulminant cerebellitis following a course of antiviral for H1N1 virus (swine flu). Often thought to follow a benign course, we illustrate with this case the potential for severe morbidity with acute cerebellitis. Following the development of florid bilateral cerebellar symptoms, this patient acutely deteriorated with a drop in her conscious level secondary to hydrocephalus. This necessitated neurosurgical intervention for placement of an external ventricular drain. Viral PCR on cerebrospinal fluid was uniformly negative although she did demonstrate positivity for Epstein–Barr virus on serum. She demonstrated significant neurological recovery over the next 3 months and at the time of discharge, was able to mobilise with a Zimmer frame despite some residual left-sided ataxia. She is currently still engaged in ongoing long-term neurorehabilitation. A review of the literature and a discussion of this rare condition follows.
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