CNS non tumor
Toxic and metabolic disorders
Alcoholic cerebellar degeneration

Author: Kymberly Gyure, M.D. (see Authors page)

Revised: 31 May 2016, last major update May 2016

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

PubMed Search: Alcoholic cerebellar degeneration

Cite this page: Alcoholic cerebellar degeneration. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/cnsalcoholic.html. Accessed June 26th, 2017.
Definition / general
  • Atrophy of the cerebellar vermis seen in the setting of chronic alcoholism
Essential features
  • Characterized clinically by ataxia and gait disturbances in the setting of chronic alcoholism
  • Pathologic features include cerebellar atrophy affecting the anterior / superior vermis with a loss of Purkinje cells and corresponding Bergmann gliosis
Epidemiology
  • Occurs in approximately 10% of alcoholic patients
Sites
  • Anterior / superior cerebellar vermis
Pathophysiology
  • Cerebellar changes may be related in part to thiamine deficiency
  • Alterations in GABA receptor dependent neurotransmission have also been proposed as a pathogenic mechanism
Clinical features
  • Truncal ataxia
  • Unsteady gait
  • Nystagmus
  • May be clinically asymptomatic in some individuals
Laboratory
  • No specific laboratory abnormalities
Radiology description
  • Atrophy of the anterior / superior vermis
Radiology images

Images hosted on other servers:

Marked diffuse cerebellar atrophy

Prognostic factors
  • Cerebellar damage remains even after abstinence from ethanol
  • Prevention of cerebellar damage by treatment of alcoholism is recommended
Case reports
Gross description
  • Atrophy of the anterior / superior cererellar vermis with widened sulci
Gross images

Images hosted on PathOut servers:

Image provided by Dr. Kymberly Gyure

Microscopic (histologic) description
  • Loss of cerebellar Purkinje cells with corresponding Bergmann gliosis
  • Narrowing of the molecular layer and a reduced number of granular cells may also be seen
Microscopic (histologic) images

Images hosted on PathOut servers:

Image provided by Dr. Kymberly Gyure

Differential diagnosis
  • Age related cerebellar atrophy (generally milder)
  • Other causes of cerebellar vermal atrophy: Phenytoin use, heavy metal poisoning, or a subset of the spinocerebellar ataxias