Cerebellar degeneration is a group of diseases that manifests as progressive ataxia, that finally led to death without specific treatment. We report here two patients with cerebellar degeneration, who had shown an improvement and less progressive course, which is associated with panax ginseng intake. Patient 1 was a 60-year-old woman with multisystem atrophy (MSA) type C with 5 year history of ginseng ingestion. Patient 2 was a 54-year-old woman with spinocerebellar ataxia (SCA) type 6, who had a history of ginseng intake for 30 months. Both the patients showed atrophic change in the cerebellum by brain magnetic resonance imaging. Cerebellar functions had been semi-quantified by International Cooperative Ataxia Rating Scale (ICARS) and monitored before and after the ginseng ingestion every 6 to 12 months. In Patient 1 with MSA type C, ICARS had improved from 21 to 17.5 ± 1.8 in the following 5 years. In Patient 2 with SCA, ICARS also showed an improvement from 22 to 6.0 ± 1.0 over 30 months. However, when she stopped taking ginseng, it progressed up to 13 points in two years. These observations provide a potential disease-modifying effect of ginseng on patients with cerebellar degeneration.
Cerebellar Ataxia ; Cerebellar Diseases

Lamotrigine is an effective antiepileptic drug with few adverse effects. Nystagmus is one of the commonly observable signs of lamotrigine overdose, which may result from central nervous system involvement. However, the physiologic basis of lamotrigine-induced nystagmus is not fully understood. Here we report a patient who presented with lamotrigine-associated nystagmus that was probably related to cerebellar dysfunction.
Central Nervous System ; Cerebellar Diseases ; Humans

There have been several reports of patients with isolated lesions of the cerebellar vermis presenting with clinical features similar to those of peripheral vestibulopathy. We report a case of small, isolated hematoma in the cerebellar vermis in a patient who presented with vertigo, ipsilesional nystagmus, and body lateropulsion to the contralesional side without the usual signs or symptoms of cerebellar dysfunction. Although they present with symptoms that mimic those of peripheral vestibulopathy, and brain computed tomography shows no abnormality, as there may be a small, isolated hematoma or infarction in the cerebellar vermis. Thus, brain magnetic resonance imaging should be performed in elderly patients with vascular risk factors.
Aged ; Brain ; Cerebellar Diseases ; Cerebellar Vermis ; Hematoma ; Hemorrhage ; Humans ; Infarction ; Magnetic Resonance Imaging ; Risk Factors ; Vertigo

Periodic alternating nystagmus is a rare form of horizontal jerk nystagmus characterized by a periodical reversal in the direction of nystagmus. It implies a cerebellar disorder or lesions involving the vestibulocerebellar connections. We report a patient with an acquired form of periodic alternating nystagmus associated with meningoencephalitis. Its waveform characteristics were demonstrated by a video-nystagmogram. The brainstem lesions in our patient were thought to be responsible for her nystagmus.
Baclofen ; Brain Stem ; Cerebellar Diseases ; Humans ; Meningoencephalitis ; Nystagmus, Pathologic*

The occurrence of cerebellopontine angle(CPA) medulloblastoma is a rare phenomenon. This article describes the case of a 30-year-old man who presented with headache, nystagmus and cerebellar dysfunction of one month's duration. The tumor arose from the left flocculus or adjacent cerebellar hemishere and projected into the cerebellopontine angle. We review the literature and discuss the clinical characteristics and pathogenesis of CPA medulloblastoma.
Adult ; Cerebellar Diseases ; Cerebellopontine Angle* ; Headache ; Humans ; Medulloblastoma*

No abstract available.
Cerebellar Diseases ; Encephalitis ; Magnetic Resonance Imaging* ; Meningitis* ; Tuberculosis

The authors present the case of a patient who suffered from cerebellar dysfunction, radiographically documented brainstem compression, and neurological deterioration after proximal artery occlusion in a giant vertebral artery aneurysm. Symptom resolution was achieved after complete embolization of remained lumen of aneurysm. The cause of neurological deterioration is brainstem compression due to mass effect of the aneurysm. In order to avoid this fatal complication, it is necessary to determine appropriate therapy for the vertebral artery giant aneurysm by evaluating cerebral blood flow and other factors about growth of aneurysm.
Aneurysm* ; Arteries* ; Brain Stem ; Cerebellar Diseases ; Humans ; Vertebral Artery*

BACKGROUND & PURPOSE: Although several investigators have been studying EMG activities in projected movements, a complete and satisfactory understanding of the EMG patterns is still lacking. This present study is an attempt to define these patterns for certain stereotyped movements in a normal population, and to investigate the electrophysiologic mechanisms of abnormal movements in common extrapyramidal disorders. METHODS: 10 Patients with Parkinson's disease and 10 patients with cerebellar disease were tested with several different tasks, using stereotyped elbow flexions. They include fast active flexion(FAF), slow active flexion(SAF), fast passive flexion(FPF), slow passive flexion(SPF), and Antagonist-inhibition task. The recorded EMG activities from biceps(agonist) and triceps(antagonist) were analysed by being compared with normal patterns of the control group. RESULTS AND CONCLUSIONS: In most patients with Parkinson's disease, EMG patterns during some smooth flexion tasks(active and passive) were abnormal and were characterised by persistent co-contractions both in biceps and triceps. The EMG patterns during a fast flexion task(active and passive) were also abnormal in about half of all patients with Parkinson's disease. This study demonstrates that both slow and fast movements are abnormal in patients with Parkinson's disease, however slow movements are more difficult than fast movements in patients with Parkinson's disease. In a task designed to investigate antagonist inhibition before agonist activities, a majority of the patients with Parkinson's disease showed normal inhibition patterns. This study suggests that, contrary to previous claims, slowness of movement be not due to either failure to relax, or rigidity in antagonist muscles. In patients with cerebellar disease, EMG patterns during a fast flexion task showed prolongation of the initial biceps and/or triceps components, and it is suggested that this abnormality might be an elemental feature of dysmetria. All patients with cerebellar disease.
Basal Ganglia ; Basal Ganglia Diseases ; Cerebellar Ataxia ; Cerebellar Diseases* ; Cerebellum ; Dyskinesias ; Elbow ; Humans ; Muscles ; Parkinson Disease* ; Research Personnel

BACKGROUND: Although several investigators have been studying EMG activity in projected movment, a complete and satisfactory understanding of the EMG patterns is still lacking. This present study is an attempt to define these patterns for certain stereotyped movement in a normal population, and to investigate the electrophysiologic mechanisms of abnormal movements in extrapyramidal disorders. METHODS: 5 Patients with Parkinson's disease and 5 patients with cerebellar disease performed several different stereotyped elbow flexion tasks, and the EMG patterns from biceps and triceps were compared with control group. RESULTS: In patients with Parkinson's disease characterized, EMG pattern during a smooth felxion task was almost always abnormal and was chracterised by alternating activity in biceps and triceps. The EMG patterns during a fast flexion task were also usually abnormal although they were always composed of bursts of EMG activity of normal duration appearing alternately in the agonist and antagonist muscles. So, This study demonstrates that both slow and fast movement are clearly abnormal in these patients with diesase of the basal ganglia. In a task designed to investigate antagonist inhibition before agonist activity, a majority of the patients performed normally. CONCLUSIONS: This study suggest that, contrary to previous claims, slowness of movement is not due either to failure to relax or to rigidity of agtagonist muscles. In patients with cerebellar disease, EMG pattern during a fast flexion task showed prolongation of the initial biceps and/or triceps components, and it is suggested that this abnormality might be an elemental featrure of dysmetria. 3 of 5 patients showed the normal pattern of smooth felxion indicating that, with cerebellar deficits, smooth movements are better preserved than fast movements. The timing of the cessation of triceps activity before the initiation of biceps activity in an alternating movement was abnormal in 4 of 5 patients; this abnormality might be an elemental feature of dysdiadochokinesia.
Basal Ganglia Diseases ; Basal Ganglia* ; Cerebellar Ataxia ; Cerebellar Diseases ; Cerebellum ; Dyskinesias ; Elbow ; Humans ; Muscles ; Parkinson Disease ; Research Personnel

Metronidazole is a nitroimidazole antibiotic used for anaerobic infections, protozoan infections, and Helicobacter pylori infections. It may produce rare but well known neurological adverse effects including peripheral neuropathy, encephalopathy, cerebellar dysfunction, and seizures. We describe three patients with metronidazole-induced reversible cerebellar dysfunctions characterized by abnormal oculomotor findings, dysmetria, and ataxia. The diagnosis of metronidazole toxicity was made clinically and supported by the brain MRI findings. The neurological signs and abnormal signal intensity on MRI resolved after discontinuation of metronidazole.
Ataxia ; Brain ; Cerebellar Ataxia ; Cerebellar Diseases ; Helicobacter pylori ; Humans ; Metronidazole ; Peripheral Nervous System Diseases ; Protozoan Infections ; Seizures