Druginduced And Iatrogenic Neurological Disorders

ADCA, autosomal dominant cerebellar ataxia; CNS, central ataxia.

Alcoholic cerebellar degeneration (thiamine deficiency) 40

Vitamin E deficiency

Chronic panencephalitis of congenital rubella 41

Subacute sclerosing panencephalitis

Varicella, measles, rubella, echo, coxsackie A/B, polio, Epstein-Barr, herpes simplex Postinfectious disseminated encephalomyelitis Mumps, cytomegalic

Legionella pneumoniae 42

Mycoplasma pneumoniae Toxoplasmosis Lyme disease Plasmodium falciparum Cysticercosis Tuberculosis

Creutzfeldt-Jakob disease 43

Gerstmann-Straussler disease

Hemorrhage, ischemia 45

Astrocytoma 46


Cerebellopontine angle tumors (acoustic neurinoma, meningioma)

Metastases: lung > melanoma > breast > gynecological > gastrointestinal > lymphoma 47


In adults: lung, ovary, lymphoma In children: neuroblastoma

Multiple sclerosis 48

Miller-Fisher variant of GBS 49

Gunshot injuries, falls, traffic accidents, heat stroke 51

Minor epileptic status 52

Lafora disease

Migraine 53

Phenytoin, carbamazepine, barbiturates, lithium, piperazine, 5-fOEuorouracil, cytosine 55


Nitrofurantoin nervous system; GsS, Guillain-Barre syndrome; PNS, peripheral nervous system; SCA, spinocerebellar due to tumors or hemorrhage cause postural ataxia of head and trunk during sitting, standing, and walking. Patients frequently fall already during sitting. The classic example is medulloblastoma, which occurs most often in the cerebellum in children between 5 and 10 years of age. Cerebellar symptoms are first limited to unsteadiness of gait and stance. As a rule, there is no incoordination of the extremities when the patient is lying in bed. Postural sway is omnidirectional and contains frequency components of less than 1 Hz. In patients with such lesions, visual stabilization of posture, as evaluated by comparing sway with eyes closed and sway with eyes open, is impaired (absence of Romberg's sign). Severe postural sway is present with eyes open and is essentially unchanged with eyes closed. Fine coordinated movements of the limbs are relatively preserved. Dysarthria is frequently present, as well as saccadic slow pursuit and an inability to suppress the VOR. Transection of the restiform body gives rise to symptoms that are reminiscent of the flocculonodular syndrome.

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