The cerebellum (Latin for “little brain”) is the part of the brain responsible for controlling our balance and coordination. It monitors our movements to ensure that they are accurate, and makes the necessary adjustments if they are not. While previously thought of as concerned only with movements, new research has shown that the cerebellum plays a role in our emotions and cognition (attention, and language) as well. Some intriguing research even suggests that the cerebellum may be abnormal in children who have autism.

The cerebellum is part of the vestibular system. It is intimately involved in processing of vestibular information. Cerebellar diseases typically cause cerebellar ataxia, which is incoordination that affects the posture, balance, manual dexterity, speech, and eye movements. Depending on the part of the cerebellum that is affected, diseases of the cerebellum result in:

  • Head tremor (sometimes called titubation)
  • Nystagmus
  • Double vision
  • Dysarthria (slurred speech)
  • Dysmetria (inaccurate movements)
  • Dysdiadochokinesia (decomposition of rapid alternating movement)
  • Intention tremor (a tremor of the arms when performing tasks)
  • Gait incoordination

There are many diseases that can affect the cerebellum. The following as some causes of cerebellar pathology:

  • Toxins
    • Alcohol
    • Heavy meatls (mercury, lead, thallium, manganese)
    • Solvents (toluene, benzene)
    • Drugs of abuse (heroin, cocaine, PCP)
    • Medications (lithium, amiodarone, phenytoin, metronidazole, 5-fluorouracil, cytosine arabinoside)
  • Nutritional Deficiencies
    • Thiamine (vitamin B1)
    • Vitamin E
    • Vitamin B12
    • Co-enzyme Q10
  • Degenerative conditions
    • Multiple system atrophy
    • Cerebellar Ataxia, Neuronopathy, Vestibular Areflexia Syndrome (CANVAS)
  • Genetic diseases
    • Friedreich ataxia
    • Spinocerebellar ataxias
    • Joubert syndrome
    • Refsum disease
    • Cerebrotendinous xanthomatosis
    • Alexander disease
    • Ataxia-Telangiectasia
    • Abetalipoproteinemia
    • Ataxia-Oculomotor Apraxia
    • Xeroderma Pigmentosum
    • Episodic ataxia
    • Wilson’s disease
  • Strokes
  • Tumors
  • Autoimmune diseases
    • Multiple sclerosis
    • Hashimoto’s
    • Gluten ataxia
    • Miller-Fisher syndrome
    • GAD antibodies
  • Paraneoplastic syndromes
  • Infectious disorders
    • Prions (Creutzfeldt-Jakob disease, Gerstmann-Straussler-Scheinker disease)
    • Viral cerebellitis (Varicella Zoster Virus, Human Herpes Virus-6, JC virus, Epstein-Barr virus, measles, mumps, rubella, enteroviruses, coxsackie virus)
    • Bacteria (Mycoplasma pneumoniae, Listeria, Whipple’s, Borrelia burgdorferi)
  • Chiari Malformation
  • Superficial siderosis

This list is by no means exhaustive, and in view of the myriad of possibilities, a multitude of tests can be performed to help figure out the diagnosis. It is very important to work with a neurologist to figure out the cause of cerebellar ataxia.