To describe the use of tocilizumab in a case of severe, life threatening cerebellitis. 

Tocilizumab is an IL-6 inhibitor that was originally developed for use in the treatment of inflammatory arthritides. More recently it has found use in broader inflammatory syndromes such as cytokine release syndrome, COVID19, and giant cell arteritis. It’s use in neuroinflammatory syndromes is off label, however it has shown to be effective in many severe clinical presentations, such as fulminant MOGAD, refractory autoimmune encephalitis, and infection triggered encephalopathies, suggesting that it may have potential as a life saving treatment in a broad array of refractory and life threatening cases of neuroinflammation. Here we present the first report to our knowledge of the use of tocilizumab in a case of cerebellitis.  

This is a retrospective case report of a patient with fulminant idiopathic cerebellitis associated with influenza A infection who was treated with tocilizumab. 

Here we describe a patient who presented with severe cerebellitis and early signs of impending herniation. He was treated urgently with tocilizumab in addition to steroids and had a rapid improvement. He received 3 further doses of tocilizumab and had stepwise improvement and regaining of milestones after each dose.

Tocilizumab may be an effective adjunct treatment in cases of severe cerebellitis.