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- $Unique_ID{BRK03580}
- $Pretitle{}
- $Title{Cerebellar Degeneration, Subacute}
- $Subject{Cerebellar Degeneration Subacute Subacute Cerebellar Degeneration
- Alcoholic Nutritional Cerebellar Degeneration Multiple Sclerosis Wernicke
- Encephalopathy Paraneoplastic Cerebellar Degeneration}
- $Volume{}
- $Log{}
-
- Copyright (C) 1990 National Organization for Rare Disorders, Inc.
-
- 795:
- Cerebellar Degeneration, Subacute
-
- ** IMPORTANT **
- It is possible that the main title of the article (Subacute Cerebellar
- Degeneration) is not the name you expected. Please check the SYNONYM listing
- to find the alternate names and disorder subdivisions covered by this
- article.
-
- Synonyms
-
- Subacute Cerebellar Degeneration
-
- Disorder Subdivisions:
-
- Alcoholic or Nutritional Cerebellar Degeneration
-
- Information on the following disorders can be found in the Related
- Disorders section of this report:
-
- Multiple Sclerosis
- Wernicke Encephalopathy
- Paraneoplastic Cerebellar Degeneration
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources"
- section of this report.
-
- Subacute Cerebellar Degeneration is characterized by deterioration of the
- cerebellum (an area of the brain concerned especially with muscle
- coordination and balance). It may also involve the area connecting the
- spinal cord to the brain such as the medulla oblongata, the cerebral cortex,
- and possibly the brain stem. There are two subtypes of this disorder. The
- first is Paraneoplastic Cerebellar Degeneration which sometimes precedes
- cancer. The second is Alcoholic or Nutritional Cerebellar Degeneration which
- is caused by a lack of the vitamin B-1 (thiamine) and is not related to
- cancer.
-
- Symptoms
-
- Common symptoms of Subacute Cerebellar Degeneration include:
-
- impaired muscle coordination (ataxia) of the limbs (especially of the
- arms in Paraneoplastic Cerebellar Degeneration, and of the legs in
- Alcoholic or Nutritional Cerebellar Degeneration)
-
- difficulty in articulation of speech (dysarthria), which is especially
- noticeable in Paraneoplastic Cerebellar Degeneration
-
- difficulty in swallowing (dysphagia)
-
- loss of reason (dementia), occurring in approximately half the patients
- with Paraneoplastic Cerebellar Degeneration
-
- involuntary rapid movements of the eyeball in a horizontal or vertical
- direction (nystagmus)
-
- double-vision (diplopia)
-
- vertigo (dizziness)
-
- paralysis of the eye muscles (ophthalmoplegia)
-
- difficulty in walking if the patient has Alcoholic/Nutritional Cerebellar
- Degeneration
-
- In Subacute Cerebellar Degeneration, there is a loss of nerve cells
- (Purkinje cells) throughout the cerebellum. A CT scan may show enlargement
- of the fourth ventricle which is the area in the brain between the spinal
- cord and the rest of brain, as well as areas of the cerebellum. Examination
- of cerebrospinal fluid is usually normal except that it may show a high
- amount of lymph cells (white blood cells formed in lymphoid tissue) and an
- elevated protein level.
-
- Causes
-
- The causes of Subacute Cerebellar Degeneration are as follows.
-
- Paraneoplastic Cerebellar Degeneration may be an autoimmune disorder.
- Autoimmune disorders are caused when the body's natural defenses (antibodies,
- lymphocytes, etc.) against invading organisms suddenly begin to attack
- healthy tissue.
-
- Alcoholic/Nutritional Cerebellar Degeneration is associated with a
- thiamine deficiency. Secondary thiamine deficiency results from increased
- requirements for thiamine, and from impaired absorption or impaired
- utilization of the vitamin. Alcoholics tend to eat few thiamine containing
- foods, they may absorb or utilize the vitamin poorly, and they normally
- require larger than normal amounts of thiamine.
-
- Affected Population
-
- In Paraneoplastic Cerebellar Degeneration, the average age of onset is 50,
- with males affected more often than females. This form of cerebellar
- degeneration may precede cancer. Alcoholic or Nutritional Cerebellar
- Degeneration affects alcoholics and people with thiamine deficiency. It is
- not related to cancer and is more common than the paraneoplastic type.
-
- Related Disorders
-
- Symptoms of the following disorders can be similar to those of Subacute
- Cerebellar Degeneration. Comparisons may be useful for a differential
- diagnosis:
-
- Multiple Sclerosis is a chronic disease of the central nervous system,
- which may be progressive, relapsing and remitting, or stable. MS is
- characterized by small lesions called plaques that form randomly throughout
- the brain and spinal cord. These patches prevent proper transmission of
- nervous system signals and thus result in a variety of neurological symptoms
- including visual difficulties (blind spots, double vision, nystagmus),
- impairment of speech, abnormal skin sensations (paresthesias) or numbness,
- walking disturbance and difficulties with bladder or bowel function. (For
- more information on this disorder, choose "Multiple Sclerosis" as your search
- term in the Rare Disease Database).
-
- Wernicke Encephalopathy is a degenerative brain disorder characterized by
- a deficiency of thiamine. It is marked by loss of coordination (ataxia) and
- apathy, confusion, disorientation or delirium. Various vision dysfunctions
- may also develop. This disorder often occurs in conjunction with Korsakoff
- Syndrome which involves a Vitamin B1 (thiamine) deficiency usually caused by
- alcoholism. Wernicke Encephalopathy can be severely disabling and life
- threatening if it is not recognized and treated early. (For more
- information, on this disorder, choose "Korsakoff" or "Wernicke" as your
- search term in the Rare Disease Database).
-
- Paraneoplastic Cerebellar Degeneration is associated with and often may
- precede the development of several types of cancer. It occurs most often in
- patients with lung cancer (especially small-cell carcinoma), but may also
- occur in patients with cancers of the ovary, breast, stomach, or uterus, as
- well as in patients with Hodgkin's Disease. Hodgkin's Disease is a form of
- cancer of the lymphatic system, especially the lymph nodes. Tumors occur in
- the lymph nodes (places where lymphatic vessels unite) and/or the area around
- the nodes. Fever, night sweats, and weight loss may occur along with swollen
- lymph nodes. (For more information on this disorder, choose "Hodgkin's
- Disease" as your search term in the Rare Disease Database).
-
- Therapies: Standard
-
- Paraneoplastic Cerebellar Degeneration may improve after successful treatment
- of the underlying cancer. For Alcoholic/Nutritional Cerebellar Degeneration,
- thiamine is given along with other B vitamins, usually relieving the
- condition if the patient stops drinking alcohol and resumes a normal diet.
-
- In cases of X-linked inherited Subacute Cerebellar Degeneration, genetic
- counseling may be of benefit for patients and their families. Other
- treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- The National Cancer Institute conducts clinical trials on new drugs being
- tested for Hodgkin's Disease and other forms of cancer. To learn about the
- locations of these investigations, contact the Cancer Information Service, 1-
- 800-4-CANCER.
-
- This disease entry is based upon medical information available through
- March 1991. Since NORD's resources are limited, it is not possible to keep
- every entry in the Rare Disease Database completely current and accurate.
- Please check with the agencies listed in the Resources section for the most
- current information about this disorder.
-
- Resources
-
- For more information on Subacute Cerebellar Degeneration, please contact:
-
- National Organization for Rare Disorders
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- American Cancer Society
- 1599 Clifton Rd., NE
- Atlanta, GA 30329
- (404) 320-3333
-
- NIH/National Institute of Neurological Disorders & Stroke (NINDS)
- 9000 Rockville Pike
- Bethesda, MD 20892
- (301) 496-5751
- (800) 352-9424
-
- NIH/National Cancer Institute
- 9000 Rockville Pike, Bldg. 31, Rm. 1A2A
- Bethesda, MD 20892
- 1-800-4-CANCER
-
- The National Cancer Institute has developed PDQ (Physician Data Query), a
- computerized database designed to give the public, cancer patients and
- families, and health professionals quick and easy access to many types of
- information vital to patients with this and many other types of cancer. To
- gain access to this service, call:
- Cancer Information Service (CIS)
- 1-800-4-CANCER
- In Washington, DC and suburbs in Maryland and Virginia, 636-5700
- In Alaska, 1-800-638-6070
- In Oahu, Hawaii, (808) 524-1234 (Neighbor islands call collect)
-
- For genetic information and genetic counseling referrals:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown and
- Co., 1987. Pp. 997, 999, 2250.
-
- MENDELIAN INHERITANCE IN MAN, 8th Ed.: Victor A. McKusick; Johns Hopkins
- University Press, 1986. Pp. 1262.
-
- THE MERCK MANUAL, Volume 1, 14th Ed.: Robert Berkow, M.D., ed.-in-chief;
- Merck, Sharp, and Dohme Laboratories, 1982. Pp. 1365, 1411-1412.
-
- CHARACTERIZATION OF A cDNA ENCODING A 34-kDA PURKINJE NEURON PROTEIN
- RECOGNIZED BY SERA FROM PATIENTS WITH PARANEOPLASTIC CEREBELLAR DEGENERATION.
- H.M. Furneaux, et al.; Proc Natl Acad Sci USA (April 1989; issue 86 (8)). Pp.
- 2873-2877.
-
- A QUANTITATIVE HISTOLOGICAL STUDY OF THE CEREBELLAR VERMIS IN ALCOHOLIC
- PATIENTS. S.C. Phillips, et al.; Brain (April 1987; issue 110 (Pt 2)). Pp.
- 301-314.
-
-