Alcoholic cerebellar degeneration: A case report

Abstract

Introduction Alcohol-induced cerebellar degeneration is the commonest type of acquired toxic ataxia. The onset of the cerebellar symptoms usually occurs at middle age, with a significant history of chronic alcohol abuse. Permanent cerebellar deficits are observed among alcoholics, and they persist even with alcoholic abstinence. The cerebellum is the structure that controls the stability of the gaze, chronic cerebellar diseases and acute alcohol intoxication affect cerebellar function. Ataxia and nystagmus are neurological manifestations present in this disease. To verify vestibulocochlear disorders observed in a case of alcohol-induced cerebellar ataxia. Material and method It is a clinical case study of alcohol-induced cerebellar ataxia. The patient featured troubled walking (wide-based gait, preserved tactile sensitivity, hyperesthesia of the lower limbs, nystagmus, dysmetria, mild dysdiadochokinesia, numbness in the distal phalanges of the upper limbs, and uncoordinated movement). Results The patient evidenced bilateral hearing loss from the frequency of 3 kHz and absence of ipsilateral reflexes; magnetic resonance imaging (MRI) showed atrophy of the Cerebellar Vermis; scale for the assessment and rating of ataxia (SARA) scored 15; brainstem auditory evoked potential test (BAEP) evidenced diffused dysfunction of the auditory pathways; balance testing showed labyrinthine hypofunction with presence of bidirectional nystagmus, featuring central vestibular disorder and the falls efficacy scale (FES-1-Brazil) evidenced abnormalities. Conclusion The patient started treatment using B12 vitamin, thiamine, and physical therapy. Currently, despite reported balance improvement, he needs ambulation support. He features nystagmus, bilateral dysmetria, mild dysdiadochokinesia, continuous tinnitus in his left ear, blurred vision, and neck pain while moving it.