Abstract
BackgroundHemicerebellitisis a rare acquired condition, typical of the pediatric age. A residual switched handedness may develop after remission of acute cerebellar symptoms.Case presentationHerein we describe a motor functional MRI studyperformed in a 35-year old girl who had switched to left-handedness after acute right hemicerebellitis in childhood. During left hand tapping, we observed activation in the right primary sensori-motor cortex, right supplementary motor area and left superior cerebellum. During right hand tapping bilateral activations of primary sensori-motorcortex and superior cerebellum including the vermis and activation of the right supplementary motor area were observed. We speculate that during right hand tapping both the ipsilateral and contralateralpre-central gyri and the ipsilateral cerebellum would be engaged in order to recover the tapping internal model of action. From this perspective the ipsilateral pre-central gyrus might serve as are transmission station of information from the healthy cerebellum to the contralateral pre-central gyrus.ConclusionSelective damage of the right half of the cerebellum due to hemicerebellitis in childhood can drive shift of lateralized hand functions in the cerebrum.
Highlights
Hemicerebellitisis a rare acquired condition, typical of the pediatric age
Whilst the left lateralization during left hand tapping is consistent with ipsilateral cerebellar somatotopy [4], the bilateral cerebellar activation during right hand tapping could be interpreted according to the theory of internal models of actions
We speculate that during right hand tapping both the ipsilateral and contralateral pre-central gyri and the ipsilateral cerebellum would be engaged in order to recover the tapping internal model of action
Summary
Hemicerebellitis, namely acute inflammation of half of the cerebellum, is a rare acquired condition with obscure pathophysiology, typical of the pediatric age. It is associated with hemiatrophy of the cerebellum at follow-up [1]. MRI at 35 years of age showed right hemiatrophy of the cerebellum and fMRI during execution of. At 35 years of age, neurological examination showed intention tremor of the right hand. She could write with either hand, but writing or drawing with left hand was smooth and accurate, whereas if performed with the Mascalchi et al Cerebellum & Ataxias (2017) 4:14 cerebellar cortex (Fig. 2). A visual cue at 1 Hz using SensaVue fMRI equipment (Invivo Corporation, Gainesville, FL, USA) was delivered through a mirror attached to the head coil
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