Cerebellar Cognitive Affective Syndrome (CCAS), also known as Schmahmann syndrome, is a disorder involving deficits in executive function, spatial cognitive abilities, language, and affective regulation due to damage to the cerebellum. This case is a major challenge for clinicians due to its diverse symptoms, including anxiety, depression, euphoria, emotional libility, as well as executive, attention, and visuospatial deficits. The management of CCAS, especially in children, is difficult due to limited data and a lack of controlled research. This report describes the case of a 13-year-old girl with a history of epilepsy and post-ictal intellectual disability who experienced impaired coordination, severe aggressiveness, and behavioral disorders that led to the diagnosis of CCAS. Treatment with a combination of Fluoxetine, which acts as a serotonin reuptake inhibitor in improving mood, and Aripiprazole, a third-generation antipsychotic, provided significant improvements in the patient's emotional regulation, social functioning, and cognitive abilities. The combination of Fluoxetine and third-generation antipsychotics showed promising results for the management of CCAS in pediatric patients. This study emphasizes the importance of early diagnosis of CCAS to avoid misdiagnosis and ensure effective treatment. Nonetheless, more research is needed to evaluate the long-term effectiveness and safety of these therapies, as well as to develop better evidence-based guidelines