Occasionally an alcoholic will develop a degeneration of the cerebellum, resulting in ataxia. The condition can rarely be found in nonalcoholics. It may be linked to thiamine deficiency.
Synonym: midline cerebellar degeneration
Risk factors:
(1) severe, prolonged malnutrition with weight loss
(2) long-term alcohol abuse
Clinical features:
(1) wide-based gait
(2) truncal ataxia
(3) sparing of the upper limbs
The onset may be acute or subacute but the condition is progressive.
Anatomic findings:
(1) atrophy of the superior vermis (seen on imaging studies or at autopsy)
Differential diagnosis:
(1) megaloblastic anemia associated with vitamin B12 deficiency
(2) complications of head trauma
(3) complications of seizures
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