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Classification of cerebellar disorders
How can cerebellar disorders be classified?
- Congenital/developmental (Joubert syndrome, Dandy–Walker syndrome, Chiari malformations
Chiari Malformations
| Type | Characteristics |
|---|---|
| I | Extension of tonsils into foramen magnum without brain stem involvement |
| May be asymptomatic | |
| II | Extension of tonsils and brain stem into foramen magnum, vermis may be partially complete or absent |
| Myelomeningocele is present | |
| III | Cerebellum and brain stem herniate through foramen magnum and into spinal canal |
| Can have occipital encephalocele with severe neurologic deficits | |
| IV | Incomplete or underdeveloped cerebellum |
- Acquired:
- 1. Vascular (infarction [thrombotic > embolic] or ischemia; hemorrhage [from hypertension, vascular malformation, or tumor]; vertebral dissection; basilar migraine; vascular malformation; systemic vasculitides)
- 2. Neoplasms (see later section)
- 3. Infections (acute cerebellar ataxia of childhood [possibly viral]; tuberculosis or tuberculoma; cysticercosis; bacterial infection/abscess [extension of mastoid infection]; chronic panencephalitis of congenital rubella; viral encephalitis [involving cerebellum or brainstem]; Whipple’s disease)
- 4. Inflammatory/autoimmune (multiple sclerosis, acute postinfectious cerebellitis, acute disseminated encephalomyelitis, Miller–Fisher variant of acute inflammatory polyneuropathy, anti-GAD-associated cerebellar ataxia, celiac and gluten ataxia)
- 5. Paraneoplastic (paraneoplastic cerebellar degeneration [see later section]; opsoclonus–myoclonus [secondary to neuroblastoma])
- 6. Metabolic (hypothyroidism, hyperthermia, hypoxia, deficiencies of thiamine [in those with alcoholic abuse], niacin [pellagra], vitamin E, essential amino acids, zinc)
- 7. Drugs/toxins (antiepileptic drugs [phenytoin, carbamazepine, barbiturates]; chemotherapeutic agents [5-fluorouracil, cytosine arabinoside]; heavy metals [thallium, lead, organic mercury])
- 8. Trauma (postconcussion syndrome, intracranial hematoma, brain contusion)
- • Degenerative (multiple systems atrophy [cerebellar type], Creutzfeld–Jakob disease)
- • Inherited/genetic (autosomal dominant, autosomal recessive, episodic mutations)
