Cerebellar atrophy

Introduction

The brain consists of different parts, including the cerebellum. It plays an important role in coordinating and fine-tuning the movements of various muscles and in maintaining balance. It is also believed to be involved in many cognitive and emotional abilities.

It is found in the posterior fossa of the skull. It is located under the cerebrum and behind the brain stem. The cerebellum is covered by the cerebellum tent, which separates the cerebellum from the cerebrum.

Classification of cerebellar atrophy

A cerebellar atrophy is a proven tissue loss of the cerebellum. This means that the cerebellum is getting smaller and can no longer completely fulfill its tasks. It is divided into three areas, each with different functions.

Depending on the extent to which one or more areas are affected, the functional failures are differently pronounced. Depending on the causes, certain areas of the cerebellum tend to shrink. Depending on the cause, one observes increased shrinkage of the cerebellar cortex or the cerebellar marrow. The exact effects regarding the mass of tissue loss of the cerebellum are controversially discussed.

Causes

The causes of tissue loss in the cerebellum are very diverse and can occur at any age. The causes and the resulting diagnostics and therapy can be classified according to three groups of affected persons: Furthermore, cerebellar atrophies can be divided into three forms, in which the groups affected are represented to varying degrees:

  • Affected persons who fall ill before the age of 25 and whose siblings are also affected or if the cerebellar atrophy occurs sporadically.
  • Affected persons, in whom the symptoms of cerebellar atrophy are variable and one parent is affected.
  • Patients who fall ill after the age of 40 and if the disease occurs sporadically.
  • Inherited forms: In most cases this is an autosomal dominant inheritance. A further distinction is made here depending on the accompanying symptoms and depending on which cerebellar area or, if applicable, which other brain areas are most affected.
  • Symptomatic forms are usually caused within the framework of a tumor disease, by prion viruses or by toxic substances such as alcohol or drugs (e.g. cytostatics).

    It is assumed that antibodies are initially directed against the tumor tissue. Often, the cerebellar atrophies are recognizable before the tumor disease. These are often small cell bronchial carcinomas or gynecological tumors.

  • Sporadic forms are often found in the context of multiple tissue atrophy.

    Otherwise they are called sporadic forms if the other two groups of causes mentioned can be excluded.

Atrophy of the cerebellum can be caused by alcohol (symptomatic form). Some researchers suspect that the cerebellum in particular is sensitive to the toxic effects of alcohol. In the context of chronic alcoholism, tissue loss in the cerebellum can manifest itself in the form of the Charcot triad, which is characteristic of cerebellar disorders: Double vision, balance or coordination disorders, and a speech disorder.

A tremor of the eye is observed less frequently. Depending on the extent and the affected cerebellar area, the symptoms vary. Some researchers have observed a reduction in the size of the cerebellar worm, which is part of the vestibulocerebellum, in particular, when alcohol-induced tissue loss of the cerebellum occurs.

The vestibulocerebellum is a part of the cerebellum that receives information from the organs of equilibrium and is responsible for the coordination of head posture, head and eye movements. As a result, there are often limitations and functional deficits in the corresponding cerebellar areas. It is also suspected that the grey matter is particularly affected by alcohol-induced cerebellar atrophy.

For example, speech disorders in atrophy of the cerebellum caused by alcohol are different from speech disorders in cerebellar damage caused by other diseases, such as multiple sclerosis. In the former, the speech disorder is characterized by unclear pronunciation and varying volume. In the second case, a slow, choppy, blurred speech melody is often observed.

Both the toxic effect of the alcohol itself and probably a resulting thiamine and vitamin B deficiency can cause cerebellar atrophy.A general laboratory examination and a determination of the vitamins, as well as a determination of the alcohol abuse markers, such as the carbohydrate deficient transferrin (CTD) can provide information. A further cerebellar atrophy can be stopped by abstinence from alcohol and administration of the missing vitamins. Treatment of the alcohol disorder is recommended.

If alcohol consumption continues, the atrophy of the cerebellum continues. Also, the effect of alcohol during pregnancy on the unborn child is very critical with regard to the growth of the cerebellum and the growth and functionality of other structures. Alcohol during pregnancy can cause, among other things, atrophy of the cerebellum. Therefore, we urgently warn against alcohol consumption during pregnancy.