Atrophy of the cerebellum

Cerebellar atrophy - This is a clearly expressed, rapidly progressing pathology that develops in the event of failures in metabolic processes, often associated with structural anatomical abnormalities.

[1], [2], [3],

Causes of the cerebellar atrophy

The cerebellum itself is an anatomical formation (older than even the middle brain), consisting of two hemispheres, in the connecting furrow between which is a cerebellar worm.

The causes of cerebellar atrophy are very different and include a fairly extensive list of diseases that can damage the cerebellum and its associated connections. On this basis, it is difficult to classify the causes that led to this disease, but it is worthwhile to highlight at least some:

• Consequences of meningitis.
• Cysts of the brain located in the zone of the posterior cranial fossa.
• Tumors of the same localization.
• Hyperthermia. Sufficiently long thermal stresses for the body (heat stroke, high temperature performance).
• The result of manifestation of atherosclerosis.
• The consequences of a stroke.
• Virtually all pathological manifestations associated with processes occurring in the posterior cranial region.
• Metabolic disorders.
• With intrauterine lesions of the cerebral hemispheres. The same reason can be an impetus in the development of cerebellar atrophy in a child in infancy.
• Alcohol.
• Reaction to some medicines.

[4], [5], [6], [7], [8]

Symptoms of the cerebellar atrophy

The symptomatology of this disease, like its causes, is quite extensive and is directly related to the diseases or pathology that caused it.

The most common symptoms of cerebellar atrophy are:

• Dizziness.
• Sharp headaches.
• Nausea, resulting in vomiting.
• Drowsiness.
• Hearing impairment.
• Light or significant disturbances in the walking process, (imbalance in walking).
• Hyporeflexion.
• Increased intracranial pressure.
• Ataxia. Disorder of coordination of voluntary movements. This symptom is observed both temporarily and permanently.
• Ophthalmoplegia. Paralysis of one or more cranial nerves, innervating the muscles of the eye. It can be temporary.
• Areflexia. The pathology of one or more reflexes, which is associated with a violation of the integrity of the reflex arch of the nervous system.
• Enuresis - incontinence.
• Dysarthria. The disorder of articulate speech (difficulty or distortion of spoken words).
• Tremor. Involuntary rhythmic movements of individual parts or the whole body.
• Nystagmus. Involuntary rhythmic vibrational movements of the eyes.

[9], [10]

Forms

[11], [12], [13], [14], [15], [16], [17]

Atrophy of the cerebellum worm

The cerebellum worm responds in the human body to the balance of the center of gravity of the body. For healthy functioning, the cerebellar worm receives an information signal that follows the spinocerebellar pathways from various parts of the body, the vestibular nuclei and other parts of the human body that participate in the correction and maintenance of the motor apparatus in the coordinates of space. That is, the atrophy of the cerebellum worm causes normal physiological and neurological connections to fall apart, the patient has problems with balance and stability, both at walking and at rest. Controlling the tone of the reciprocal muscle groups (mainly muscles of the trunk and neck), the cerebellum worm at its atrophy weakens its functions, which leads to disturbances in movement, constant tremor and other unpleasant symptoms.

A healthy person strains his leg muscles when standing. If there is a threat of falling, for example to the left, the left leg moves toward the intended direction of the fall. The right leg is thus torn off from the surface as when jumping. With the atrophy of the cerebellum worm, communication is broken in the coordination of these actions, which leads to instability and the patient can fall even from a small push.

[18], [19], [20], [21]

Diffuse brain and cerebellar atrophy

The brain with all its structural components is the same organ of the human body as everything else. Over time, a person grows old, and his brain grows old with him. Violated and, to a greater or lesser extent, brain activity, atrophy of its functionality: the ability to plan and monitor their actions. This, often, leads the elderly person to a distorted view of the norms of behavior. The main cause of atrophy of the cerebellum and the entire brain is the genetic component, and external factors are only a provoking and aggravating category. The difference in clinical manifestations is associated only with the primary lesion of a particular region of the brain. The main common manifestation of the course of the disease is that the destructive process gradually progresses, up to a complete loss of personal qualities.

Diffuse atrophy of the brain and cerebellum can progress due to the numerous pathological processes of various etiologies. At the initial stage of development, diffuse atrophy is similar in its symptoms to late cortical atrophy of the cerebellum, but over time, other symptoms more specific to this pathology are added to the baseline symptomatology.

The impetus to the development of diffuse cerebral and cerebellar atrophy can be both a craniocerebral trauma and a chronic form of alcoholism.

For the first time, this impairment of brain function was described in 1956, based on monitoring behavior, and after death and directly on the study of the brain itself, American soldiers who had suffered for a long time posttraumatic vegetative pressure.

To date, doctors differentiate three types of dying brain cells.

• The genetic type is a natural, genetically programmed, process of neuronal death. The person is getting old, the brain is gradually dying.
• Necrosis - the death of brain cells is due to external factors: bruises, craniocerebral trauma, hemorrhages, ischemic manifestations.
• "Suicide" of the cell. Under the influence of certain factors, the cell nucleus is destroyed. Such a pathology can be congenital or acquired under the influence of the resulting combination of factors.

The so-called "cerebellar gait" in many respects resembles the movement of a drunkard. In connection with violations of the coordination of movement, people with atrophy of the cerebellum, and the brain in general, move uncertainly, they are shaken from side to side. Especially this instability is manifested when necessary to make a turn. If the diffuse atrophy has already passed into a more severe, acute stage, the patient loses the ability not only to walk, stand, but also to sit.

[22], [23], [24]

Atrophy of the cerebellar cortex

In the medical literature, another form of this pathology is quite clearly described: late atrophy of the cerebellar cortex. The primary source of the process of the destructive cell of the brain is the death of Purkinje cells. Clinical studies show that in this case, the demyelination of the fibers (selective-selective lesion of myelin layers located in the amniotic zone of the endings of both the peripheral and central nervous system) of the jagged cells of the cells, which constitute the cerebellum. The granular layer of cells usually suffers a little. He undergoes a change in the case of an already acute, severe stage of the disease.

Cell degeneration begins with the upper zone of the worm, gradually expanding to the entire surface of the worm and further to the hemisphere of the brain. The last zones that undergo pathological changes, with the neglect of the disease and the acute form of its manifestation, are the olives. During this period, processes of retrograde (reverse) degeneration begin to take place in them.

A single etiology of such damage has not been identified to date. Physicians assume, based on their observations, that the cause of atrophy of the cerebellar cortex can be various kinds of intoxication, the development of cancer tumors, as well as progressive paralysis.

But, as unfortunate as it sounds, in most cases it is not possible to determine the etiology of the process. It is only possible to ascertain the changes in certain areas of the cerebellar cortex.

An important characteristic of atrophy of the cerebellar cortex is that, as a rule, it begins in patients already in age, differs not by a rapid course of pathology. Visual signs of the course of the disease begin to manifest itself in gait instability, problems with standing without support and support. Gradually, the pathology captures the motor functions of the hands. The patient becomes difficult to write, use cutlery and so on. Pathological disorders, as a rule, develop symmetrically. There is a tremor of the head, limbs and the whole body, the speech apparatus begins to suffer, and the muscle tone decreases.

[25], [26], [27]

Complications and consequences

The consequences of cerebellar atrophy are destructive for a sick person, as in the process of rapid development of the disease irreversible pathological processes occur. If you do not support the patient's body at the initial stage of the disease, the end result can be a complete degradation of a person as a person - this is socially and completely incapable of adequate action - in the physiological.

From a certain stage of the disease, the process of cerebellar atrophy can not be reversed, but it is possible to freeze the symptoms, not allowing them to progress further.

A patient with atrophy of the cerebellum begins to feel uncomfortable:

• There is a lack of confidence in the movements, the syndrome of "drunken" gait.
• The patient is difficult to walk, stand without support or support of close people.
• Problems with speech begin: tongue-tied tongue, incorrect construction of phrases, impossibility to express their thoughts intelligibly.
• Gradually, the manifestations of degradation of social behavior are progressing.
• Begins to visualize the tremor of limbs, the head and the entire body of the patient. It becomes difficult for him to do seemingly elementary things.

[28], [29], [30], [31], [32], [33]

Diagnostics of the cerebellar atrophy

To establish the correct diagnosis, a patient with the above symptoms should consult a neurologist, and only he is able to uniquely diagnose.

Diagnosis of cerebellar atrophy includes:

• The method of neuroimaging, which involves visual examination by a patient's doctor, checking his nerve endings for reaction to external stimuli.
• Detection of anamnesis of the patient.
• Genetic predisposition to this category of diseases. That is, whether there were cases of relatives' illness in the family of such diseases.
• Assist in diagnosing cerebellar atrophy is provided by computed tomography.
• A neonatal neurologist can refer to an ultrasound.
• MRI is sufficiently high and with great probability reveals this pathology of the cerebellum and cerebral trunk, and shows other changes entering the study area.

[34], [35], [36], [37]

Treatment of the cerebellar atrophy

Sadly, this sounds, but it is impossible to carry out classical treatment of cerebellar atrophy. In the course of this disease, you can not direct it to eliminate the cause of the pathology. Modern medicine today can offer the patient only treatment aimed to smooth out the symptoms of the disease. That is, with the help of medicamental and other methods, the neuropathologist tries to arrest a progressive disease and alleviate the general condition of the patient.

If the patient suffers from excessive excitability and irritability, or, conversely, shows complete apathy, the attending physician appoints the patient appropriate psychotropic medications.

Levomepromazine

This drug is used in the treatment of chronic melancholic conditions. It is also effective for various aetiology excitations. In this case, the dosage is assigned individually in each specific case.

Usually, the treatment course starts with a starting dose of 0.025 g, taking two to three times a day. Gradually used dose is increased to 0.075-0.1 g daily. When the desired result is achieved, the dosage starts to be reduced to a prophylactic amount of 0.05-0.0125 g.

If the patient entered with an acute form, a 2.5% solution of levomepromazine is injected intramuscularly with 1 - 2 ml. With clinical indications, the dosage increases from 0.1 g to 0.3 g per day. Side effects of the drug are mild. It is not recommended to apply this medicine to people suffering from cardiovascular diseases, hypertension, blood problems.

Such drugs as alimamazin, teralen, thioridazine effectively reduce the state of anxiety and fear, relieve tension.

Alimemazine

The drug is administered intravenously and intramuscularly. The daily dosage for adults is 10-40 mg. The daily dosage for children is 7.5-25 mg. Injections are done three to four times a day.

In case of acute manifestation of a psychiatric illness, the starting daily dosage for adults is 100-400 mg. But the quantitative component of the drug per day should not exceed: for adults - 500 mg, for people of advanced age - 200 mg.

This drug is ineffective in clearly expressed psychoses. It is used as a sedative tool of mild action. The drug alimamazine is contraindicated in patients with concomitant diseases: prostatic disease, impaired renal and hepatic function, hypersensitivity to the drug components. Do not give it and the kids to a year.

[38], [39], [40]

Teralen

The daily dosage of the drug is two to eight tablets, depending on the severity of the symptom displayed. The drug is indicated for increased nervousness, sleep disturbances, and other symptoms. Do not take this drug with increased hypersensitivity to the components of the drug, with hepatic and renal failure, parkinsonism and other diseases. You can not give it to children under seven.

Thioridazine

With mild forms of fatigue, emotional decline, the drug is taken orally at a dosage of 30 to 75 mg throughout the day. If manifestations of moderate severity are recorded, the dosage is raised to 50-200 mg per diem. If the disease of cerebellar atrophy is expressed by an acute form of psychosis, a manic-depressive condition, the daily dosage is increased to 150-400 mg (in the conditions of the polyclinic) and 250-800 mg - upon admission to the hospital. This drug should not be used for patients who have a history of severe forms of cardiovascular disease, coma of any etiology, head injuries and many others. Do not recommend thioridazine and pregnant women, mothers during lactation, children under the age of two, elderly people and people suffering from alcoholism and so on.

With manifested severe neuroses, Sonapaks is prescribed.

Sonapax

Recommended dosage:

• with mild mental disorder - 30-75 mg throughout the day.
• with average mental and emotional disorders - 50-200 mg throughout the day.
• if acute symptoms of the disorder appear - for out-patient treatment, the neuropathologist prescribes a daily dosage of 150-400 mg, if the treatment is in the hospital - the daily dosage can increase to 250-800 mg (under the doctor's control).

For children of the age of four to seven years, the dosage is somewhat lower and is 10-20 mg daily, divided into two to three doses, children aged eight to 14 years - three times a day to 20-30 mg daily, adolescents 15 to 18 years - the dosage increases up to 30-50 mg during the day.

Sonapaks is contraindicated in patients who are in the acute stage of the depressive state and do not attribute the drug to those who suffer from coma of various genesis, with severe cardiovascular damage, craniocerebral trauma and many other diseases. A complete list of contraindications can be found in the accompanying instructions for the drug.

At the initial stage of the disease, it is desirable to treat the patient at home, in the usual situation for him, as placing in a hospital is fraught with deterioration of the general condition of the ill. It is necessary to create all conditions for an active lifestyle. Such a person needs to move a lot, constantly find himself some kind of work, less to lie in the daytime. Only when acute forms of atrophy of the cerebellum the patient is placed in a hospital or a specialized boarding school, especially if there is no one to look after him at home.

Prevention

As such, prevention of cerebellar atrophy does not exist. To prevent this disease it is impossible even proceeding from the fact that medicine thoroughly knows the reasons for its occurrence. Modern medications are able to maintain a relatively satisfied state of the patient's psychosomatic and physiological condition, and in combination with good care can prolong his life, but can not be cured.

If you have such a pathology in your family, try to show yourself more often to a neurologist. Inspection will not be superfluous.

[41], [42]

Forecast

The prognosis of cerebellar atrophy is not comforting. It is almost impossible to completely cure a patient with such a diagnosis. By the efforts of physicians and close relatives, the patient's life can only be slightly normalized and prolonged.

Atrophy of the cerebellum is not treated. If this is the case, and your family is in trouble, someone from close relatives is ill, surround it with attention, create comfortable living conditions, and physicians will help to ensure that the disease does not progress so much and the patient feels satisfactory. Your care and love will help prolong his life, filling it with meaning.

[43], [44], [45], [46], [47],