Symptoms

Depending on the affected cerebellar area and the extent of tissue loss, characteristic symptoms of cerebellar atrophy occur. The cerebellum can be divided into three sections with different functions. The vestibulocerebellum mainly processes information from the vestibular organs and is responsible for the coordination of head and eye movements.

The spinocerebellum regulates walking and standing and the pontocerebellum is used for the fine regulation of motor functions and the correct execution of movements. When the vestibulocerebellum is affected, the affected person usually suffers from dizziness, balance disorders, standing insecurity, speech disorders and eye movement disorders, sometimes with double vision and eye tremors. The speech disorder is characterized by unclear pronunciation and varying volume.

This cerebellar area is often affected when alcohol is the cause of the cerebellar atrophy. If the spinocerebellum is affected, it usually shows a stance and gait insecurity, known as stance and gait ataxia. If the pontocerebellum is disappearing, the affected persons suffer from restricted, aimless grasping and trembling during these movements.

Furthermore, a delayed braking of the muscle opponents, as well as coordination disorders, speech disorders and an inability to perform rapid sequences of movements are also observed. The speech disorder is characterized by a slow, blurred, choppy speech melody. This cerebellar area is often affected when the cerebellar damage is caused by a disease such as multiple sclerosis.

In atrophy of the cerebellum, all the above-mentioned cerebellar areas can also be affected together. Researchers also suspect that there are connections between classical conditioning, phobias, and cognitive and emotional abilities with effects at the cerebellar level. Consequently, atrophy of the cerebellum may also limit and affect these abilities and areas.

Diagnosis

A survey of the affected person and a clinical examination can provide evidence of cerebellar atrophy. The doctor will ask about the patient’s medical history and biography and will examine movement, coordination, speech and eye movements. With imaging diagnostics, the extent of the cerebellar atrophy can be determined more precisely.

If the cause is genetic, a genetic diagnosis should be made and accompanying diseases should be inquired about. In the case of alcohol-related cerebellar atrophy, a blood test is necessary. An MRI examination, also known as magnetic resonance imaging, can be used to visualize the exact extent of the small reduction.

Surrounding structures can also be examined for involvement. MRI provides a kind of “dynamic view” of the cerebellum and other brain regions. The functional MRI can provide insights into temporal events and the activity of the cerebellar regions.

Depending on the aim of the examination, contrast agents are also used. The MRI is free of X-rays and there are usually no medical risks if the regulations presented during the examination are followed. For example, no items of clothing or jewelry containing metal may be worn.

Risks, the course of the examination, functional principle, procedures, indications and duration of the MRI examination of the brain are largely the same as those explained for the general MRI examination. After an MRI of the brain, the sectional images of the brain can be displayed on the PC monitor in every plane. In this way, structures of the cerebellum can be visualized in relative detail and cerebellar atrophies can be visualized relatively accurately.