Cerebellar Dysfunction and Ataxia in Patients with Epilepsy: Coincidence, Consequence, or Cause?

Marcián, Václav; Filip, Pavel; Bareš, Martin; Brázdil, Milan

doi:10.7916/d8kh0nbt

Cited by 15 publications

(6 citation statements)

References 102 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…20 The association between epilepsy and cerebellar atrophy is well-known, 21 but what is cause, what is effect, and what is coincidence remain areas of research. 22,23 Our COE subjects did not initially present with cerebellar signs. The association with cerebellar atrophy might suggest that this is a consequence of the epileptic seizures and/or medical treatment.…”

Section: Discussionmentioning

confidence: 66%

See 1 more Smart Citation

Differences in brain changes between adults with childhood‐onset epilepsy and controls: A prospective population‐based study

Sillanpää

Hermann

Rinne

et al. 2021

Acta Neuro Scandinavica

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 66%

“… 29 The previous literature suggests the failure of a damaged cerebellum to inhibit epileptic seizures. 23 As a consequence, epilepsy is often, but not always, 30 drug‐resistant.…”

Section: Discussionmentioning

confidence: 99%

Differences in brain changes between adults with childhood‐onset epilepsy and controls: A prospective population‐based study

Sillanpää

Hermann

Rinne

et al. 2021

Acta Neuro Scandinavica

View full text Add to dashboard Cite

show abstract

“…9,[11][12][13][14][15][16] Many studies suggest a negative correlation between total cerebellar volume and duration of epilepsy [11][12][13][14][15] and earlier age at seizure onset. 11,17 Bilateral reduction of cerebellar GMV in TLE regardless of the side of seizure focus has been reported by some authors, 14,[18][19][20] whereas others have found GMV cerebellar changes most pronounced ipsilateral to the side of the epileptogenic focus. 21,22 Evidence for changes in cerebellar white matter has been inconsistent.…”

Section: Introductionmentioning

confidence: 87%

Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA‐Epilepsy study

Kerestes,

Perry,

Vivash

et al. 2024

Epilepsia

View full text Add to dashboard Cite

ObjectiveThe intricate neuroanatomical structure of the cerebellum is of longstanding interest in epilepsy, but has been poorly characterized within the current corticocentric models of this disease. We quantified cross‐sectional regional cerebellar lobule volumes using structural magnetic resonance imaging in 1602 adults with epilepsy and 1022 healthy controls across 22 sites from the global ENIGMA‐Epilepsy working group.MethodsA state‐of‐the‐art deep learning‐based approach was employed that parcellates the cerebellum into 28 neuroanatomical subregions. Linear mixed models compared total and regional cerebellar volume in (1) all epilepsies, (2) temporal lobe epilepsy with hippocampal sclerosis (TLE‐HS), (3) nonlesional temporal lobe epilepsy, (4) genetic generalized epilepsy, and (5) extratemporal focal epilepsy (ETLE). Relationships were examined for cerebellar volume versus age at seizure onset, duration of epilepsy, phenytoin treatment, and cerebral cortical thickness.ResultsAcross all epilepsies, reduced total cerebellar volume was observed (d = .42). Maximum volume loss was observed in the corpus medullare (dmax = .49) and posterior lobe gray matter regions, including bilateral lobules VIIB (dmax = .47), crus I/II (dmax = .39), VIIIA (dmax = .45), and VIIIB (dmax = .40). Earlier age at seizure onset ( = .05) and longer epilepsy duration ( = .06) correlated with reduced volume in these regions. Findings were most pronounced in TLE‐HS and ETLE, with distinct neuroanatomical profiles observed in the posterior lobe. Phenytoin treatment was associated with reduced posterior lobe volume. Cerebellum volume correlated with cerebral cortical thinning more strongly in the epilepsy cohort than in controls.SignificanceWe provide robust evidence of deep cerebellar and posterior lobe subregional gray matter volume loss in patients with chronic epilepsy. Volume loss was maximal for posterior subregions implicated in nonmotor functions, relative to motor regions of both the anterior and posterior lobe. Associations between cerebral and cerebellar changes, and variability of neuroanatomical profiles across epilepsy syndromes argue for more precise incorporation of cerebellar subregional damage into neurobiological models of epilepsy.

show abstract

“…The cerebellum is also believed to modulate seizure activity, but the concept of cerebellar epilepsy is controversial. Ataxia is a presenting manifestation of various epilepsies such as SCN1A , SCN2A , KCTD7 , KCNJ10 , and CACNA1A gene mutations and of various deficiency disorders and metabolically conditioned diseases (such as folic acid transport disorders, vitamin E deficiency, and glucose transporter 1 deficiency) 6 . Ataxia may also be seen as a consequence of epilepsy, possibly due to cerebellar atrophy (but the pathogenesis not yet clear) or as an adverse effect of antiepileptic drugs such as phenytoin, carbamazepine, clobazam, clonazepam, and zonisamide, among others.…”

Section: Discussionmentioning

confidence: 99%

Post‐infectious cerebellar ataxia following COVID‐19 in a patient with epilepsy

Chattopadhyay

Sengupta

Basu

2022

Clinical & Exp Neuroim

View full text Add to dashboard Cite

Background Various neurological manifestations have been described in relation to severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and coronavirus disease 2019 (COVID‐19). However, the development of cerebellar ataxia after recovery from COVID‐19 is rare. We present a case of cerebellar ataxia 3 weeks after recovery from COVID‐19. Case Presentation A 70‐year‐old male patient from an urban area of India presented with ataxia. He was hypertensive and had been receiving treatment for post‐traumatic epilepsy for the previous 3 years. He had previously had laboratory‐confirmed COVID‐19 infection with mild symptoms that resolved within 2 weeks. However, 3 weeks after symptom improvement, he developed severe pan‐cerebellar ataxia. Investigations were suggestive of post‐infectious cerebellar ataxia. Other causes of ataxia were excluded. He responded well to pulse methylprednisolone therapy and was discharged with mild tremor and ataxia. Conclusion Post‐infectious cerebellar ataxia is an unusual presentation after COVID‐19. The clinician should be aware of such complications following COVID‐19 infection as early diagnosis and proper management leads to better outcomes in many patients.

show abstract

Cerebellar Dysfunction and Ataxia in Patients with Epilepsy: Coincidence, Consequence, or Cause?

Cited by 15 publications

References 102 publications

Differences in brain changes between adults with childhood‐onset epilepsy and controls: A prospective population‐based study

Differences in brain changes between adults with childhood‐onset epilepsy and controls: A prospective population‐based study

Patterns of subregional cerebellar atrophy across epilepsy syndromes: An ENIGMA‐Epilepsy study

Post‐infectious cerebellar ataxia following COVID‐19 in a patient with epilepsy

Contact Info

Product

Resources

About