The Aetiologic Spectrum of Cerebellar Ataxia: Acquired Causes of Ataxia
Peter K Todd, University of Michigan Medical School, Ann Arbor, Michigan, USA
J Paul Taylor, St. Jude Children' Research Hospitals, Memphis, Tennesee, USA
Published online: March 2009
DOI: 10.1002/9780470015902.a0021592
Abstract
Ataxia is a common finding in patients seen in neurological practice and can be the result of a wide variety of causes. Although
cerebellar degeneration can be chronic and slowly progressive, acute cerebellar swelling due to infarction, oedema or haemorrhage
can have rapid and catastrophic effects and is a true neurological emergency. Here we set out to briefly describe the clinical/anatomical
correlates of cerebellar disease and to provide a broad differential diagnosis for patients who present with cerebellar ataxia.
This article specifically focuses on acquired causes of cerebellar ataxia. A separate complementary article discusses common
hereditary causes of cerebellar ataxia.
Key Concepts
-
Clinical syndromes associated with cerebellar dysfunction may be divided into syndromes that predominantly affect the midline
cerebellar structures (gait and ocular dysfunction predominant) or the cerebellar hemisphere(s) (ipsilateral appendicular
ataxia, dysarthria).
-
Acute onset of cerebellar ataxia is most commonly associated with vascular disorders (stroke or haemorrhage), toxins or infectious
aetiologies.
-
Subacute onset cerebellar ataxia can result from a variety of causes, including infectious, neoplastic, autoimmune and metabolic
abnormalities. Many of these causes of ataxia are treatable.
-
Most slowly progressive cerebellar ataxias result from neurodegenerative aetiologies, either inherited or sporadic.
Keywords: multiple sclerosis; paraneoplastic cerebellar degeneration; vitamin E deficiency; multiple system atrophy; toxins
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