Acupuncture for primary autoimmune cerebellar ataxia: A CARE-compliant case report with two-year follow-up

AbstractRationale: Primary autoimmune cerebellar ataxia (PACA) is an immune-mediated ataxia often lacking disease-specific antibodies, making timely therapy challenging. We explored whether integrative acupuncture might aid recovery alongside immunomodulation. Patient concerns: A 28-year-old woman presented with right lower limb weakness, gait stiffness and unsteadiness, dysarthria, and intention tremor. Diagnoses: The patient was diagnosed with PACA and had a history of immunosuppressive therapy. Interventions: In addition to ongoing immunomodulatory treatment, the patient received a standardized acupuncture regimen delivered during hospitalization and continued as maintenance in the outpatient setting. Outcomes: Speech fluency and motor coordination improved markedly. At discharge, the Scale for the Assessment and Rating of Ataxia decreased from 20 to 14, and the modified Rankin Scale improved from 3 to 2. Clinical symptoms remained stable at the 2-year follow-up, without reported adverse events. Lessons: Integrative acupuncture may be a feasible adjunct in PACA, particularly for enhancing motor coordination and functional status; controlled studies are warranted to confirm efficacy and define indications.