A variety of injuries and illnesses can be pinpointed as the cause of cerebellar disease, along with some medications. But what is cerebellar disease, what causes the condition, and how can it be treated?

What Is Cerebellar Atrophy?

So what is cerebellar disease? Cerebellar disease is a condition that involves cerebellum, the part of the brain located at the base of the brain and is responsible for fine movements, posture, motor skills, and other movement. A number of associated conditions can affect the cerebellum, including cancer, genetic disorders, ataxias (muscle control failure that leads to movement disorders), and degeneration.

Cerebellar degeneration involves the deterioration of neurological tissues in the cerebellum, causing the nerve cells to deteriorate and die. Often, the conditions that caused this degeneration may also affect other areas of the central nervous system, so cerebellar degeneration is sometimes also accompanied by issues with the spinal cord, cerebral cortex, brain stem, and more.

What Cerebellar Disease Symptoms Should You Look Out For?

When the neurological connections in the cerebellum are disrupted, it can result in a variety of cerebellar atrophy symptoms which may mirror those of a stroke. These may include an unsteady gait, tremors, jerky movements, and slurred speech. Other cerebellar disease symptoms may include:

• Poor coordination
• Unsteady walk, a tendency to stumble
• Difficulty with fine motor tasks (eating, writing, buttoning a shirt, etc.)
• Change in speech
• Rapid, involuntary eye movements
• Difficulty swallowing

Unfortunately, these cerebellar disease symptoms can seriously affect a person’s daily life. In some instances, symptoms of the disease can be alleviated, but many patients with cerebellar disease can experience long-lasting or permanent symptoms.

What Are the Most Common Causes of Cerebellar Disease?

The causes of cerebellar disease can be any number of injuries, disorders, or diseases. The condition may be caused by neurological diseases or conditions such as Alzheimer’s, cerebral palsy, epilepsy, Parkinson’s disease, dementia, and multiple sclerosis. Stroke may also be a cause of cerebellar atrophy. In some cases, an infectious disease or tumor may contribute to cerebellar atrophy. Traumatic brain injuries have also been shown to cause the disease.

Outside of natural causes, some pharmaceutical drugs have been tied to cerebellar atrophy, such as Dilantin, or phenytoin.

Can Dilantin Cause Cerebellar Atrophy?

Dilantin (also known by its generic name, phenytoin) is an epilepsy medication manufactured by pharmaceutical giant Pfizer, Inc., used to reduce seizure activity. Dilantin has been around for decades, and was approved by the U.S. Food and Drug Administration (FDA) back in 1953. Since its approval more than half a century ago, Dilantin has become one of the most widely used anticonvulsant options on the market.

Unfortunately, Dilantin has also been shown to be linked to cerebellar atrophy. As early as the 1990s, studies have linked the medication with the degenerative brain condition.

In 1994, a study aimed to examine the link while also considering the fact that seizures – which Dilantin is prescribed to treat – can cause cerebellar atrophy. This study determined that the link between Dilantin use and cerebellar atrophy was significant, even after accounting for the potential effects of seizure brain damage.

Other studies since then have expanded the understanding of the link between Dilantin toxicity and cerebellar atrophy. Researchers have determined that the condition usually affects patients whose drug serum levels in their blood are above the therapeutic range, although the condition can occur when drug serum levels are normal.

Further studies show that children can be affected by the condition after being treated with Dilantin. And studies have continued to affirm the relationship between cerebellar disease and Dilantin usage.

In 2003, a study found that moderate to severe cerebellar atrophy was caused by long term use of Dilantin. Other studies have repeated this conclusion. This means that while cerebellar disease is a risk of any Dilantin use, long-term use of Dilantin (or taking Dilantin in higher doses) increases that risk.

How Does Treatment Work?

In some cases, if the underlying cause is treated, cerebellar atrophy can be temporary. For example, if the disorder is caused by an infection or tumor, treating those conditions can help to resolve cerebellar atrophy. The treatment for these cases will depend entirely on what is causing the cerebellar atrophy.

However, cerebellar atrophy may also be a permanent condition. If the underlying cause can not be treated, doctors may focus on managing a patient’s symptoms through physical and occupational therapy. The exercises taught in these therapies can help individuals walk more normally and complete daily activities with more success.

For some patients, discontinuing Dilantin treatment can improve cerebellar atrophy. However, this is not always the case. When treatment with Dilantin is long term, patients have reportedly been left with persistent injuries including cerebellar ataxia (lack of muscle coordination).