Background: Alcohol-related cerebellar degeneration is one of the commonest acquired forms of cerebellar ataxia. The exact pathogenic mechanisms by which alcohol leads to cerebellar damage remain unknown. Possible autoreactive immune mediated mechanisms have not been explored previously Chronic small vessel ischemic changes and cerebral volume loss are mildly prominent for age, the latter in keeping with history of alcohol abuse. Case Discussion Vermian atrophy is a typical feature of chronic alcohol excess Cranial CT scan and MRI revealed atrophy of the cerebellar vermis and dorsal part of the cerebellum. Though neurological signs slightly improved after the admission to our hospital and the abstinence from alcohol abuse, ataxic gait and hyperreflexia of the extremities have continued. Patient 2 was a 58-year-old man Alcohol-related cerebellar degeneration is one of the commonest acquired forms of cerebellar ataxia. The exact pathogenic mechanisms by which alcohol leads to cerebellar damage remain unknown. Possible autoreactive immune mediated mechanisms have not been explored previously
Cerebellar degeneration is common in alcoholics (Torvik and Torp 1986; Victor and Laureno 1978). Researchers have looked at cerebellar damage in the brains of alcoholics during postmortem examination. The most consistently reported structural damage in the cerebellum of alcoholics is tissue volume loss in the anterior superior vermis (Victor et. 20. Spampinato MV, Castillo M, Rojas R, Palacios E, Frascheri L, Descartes F. Magnetic resonance imaging findings in substance abuse: alcohol and alcoholism and syndromes associated with alcohol abuse. Top Magn Reson Imaging 2005; 16:223 -230 [Google Scholar 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
Another type of MRI application, magnetic resonance spectroscopy imaging (MRSI), provides information about the neurochemistry of the living brain. MRSI can evaluate neuronal health and degeneration and can detect the presence and distribution of alcohol, certain metabolites, and neurotransmitters CNS nontumor - Alcoholic cerebellar degeneration. This website is intended for pathologists and laboratory personnel but not for patients
Preliminary qualitative CT neuroradiological studies reported vermian and cerebellar shrinkage in alcoholics, 23-25 but it was not until the introduction of MRI that the cerebellum was properly assessed Perform head imaging, such as a CT scan or MRI. In patients with ataxia secondary to alcohol abuse, imaging might reveal degeneration of the cerebellar vermis. Perform laboratory tests, such as inflammatory markers, vitamin levels, and thyroid function testing to detect possible toxic-metabolic or inflammatory causes The relationship of alcoholic cerebellar degeneration and Wernicke disease was further explored by Victor and colleagues in their book on Wernicke disease (Victor et al., 1989). At least 87% of their cases of Wernicke disease had gait ataxia. Ataxia on heel to shin testing occurred in 20% but only in a few cases was it severe Cerebellar atrophy is a recognised result of alcohol-related cerebellar degeneration. The anterior superior cerebellar vermis is predominantly affected [ 3 , 4 ] with the Purkinje cell, granular and white matter layers being most susceptible [ 2 ] Cerebellar signal intensity alterations can be observed in both AL and NA patients [73, 74].Cerebellar involvement on imaging is rather rare but autopsy studies have demonstrated that the anterior-superior vermis or anterior hemisphere is affected in more than half of patients with WE .The involvement of the caudate nuclei, in particular of the capita, may be due to their adjacent position.
In alcoholic cerebellar degeneration, symptoms usually begin to occur in middle-aged individuals with a history of chronic alcohol abuse. These symptoms are caused by thiamine deficiency, which also occurs in nutritional cerebellar degeneration Paraneoplastic cerebellar degeneration is an immune-mediated disorder that affects cerebellar cortex, usually Figure 1. Brain MRI of a patient with alcoholic cerebellar degeneration (ACD). Sagittal T1-weighted brain MRI disclosed marked cerebellar atrophy restricted to the superior vermis (A). Axial T1-weighted MRI of the same patient.
. Clinical Syndrome The clinical syndrome of alcoholic cerebellar degeneration is remarkably stereotyped. The usual. [slideplayer.com] It is our ambition to present a complete survey of all medical phenomena named for a person, with a biography of that person. Disclaimer: Whonamedit. Alcoholic cerebellar degeneration. Alcoholic cerebellar degeneration is the most common form of acquired toxic ataxia and is a frequent neurological complication in alcoholics. Cerebellar symptoms usually begin in middle-aged, and there is a marked history of chronic alcohol abuse Subacute cerebellar degeneration may occur in association with a cancer (paraneoplastic cerebellar degeneration) or lack of thiamine (alcoholic or nutritional cerebellar degeneration). Signs and symptoms may include ataxia, speech and swallowing problems, dementia, vision problems, and vertigo. Last updated: 10/14/201
Cerebellar atrophy is a common finding in alcoholics in both imaging and autopsy studies [57, 58]. Because L1 is a neuronal survival factor, ethanol effects on L1 expression could mediate alcoholic.. Cerebellar degeneration. Author: Julie Doll BSc, MSc • Reviewer: Uruj Zehra MBBS, MPhil, PhD Last reviewed: August 31, 2020 Reading time: 10 minutes The cerebellum is one of the chief parts of the brain, receiving massive sensory input from different regions.A lesion in the cerebellum severely affects the body and eye movements due to disruption of the vestibular system
A CT scan or MRI of your brain might help determine potential causes. An MRI can sometimes show shrinkage of the cerebellum and other brain structures in people with ataxia. It may also show other treatable findings, such as a blood clot or benign tumor, that could be pressing on your cerebellum. Lumbar puncture (spinal tap) Systemic disorders include alcoholism (alcoholic cerebellar degeneration), thiamin deficiency, celiac disease, heatstroke, hypothyroidism, and vitamin E deficiency. Toxins that can cause cerebellar dysfunction include carbon monoxide, heavy metals, lithium, phenytoin, and certain solvents
Developed by renowned radiologists in each specialty, STATdx provides comprehensive decision support you can rely on - Alcoholic Encephalopath Some investigators have suggested that alcoholic cerebellar degeneration results from thiamine deficiency and represents the same disease as Wernicke's encephalopathy, an acute, transient stage of alcohol-related neurological problems which include confusion and abnormalities in oculomotor and gross muscle control (Cook et al., 1998; Reuler et. Alcoholic cerebellar degeneration is a common neurological complication seen in alcoholics. The toxic and metabolic effects of ethanol combined with thiamine (B1) deficiency is thought to cause atrophy of the anterior and/or superior vermis . Hypometabolism in the medial frontal region of the cerebral cortex is a prominent finding in alcohol- dependent patients with or without alcoholic cerebellar degeneration Acquired hepatocerebral degeneration (AHCD) is a chronic and largely irreversible neurologic syndrome associated with acquired liver disease. 1 It is often combined with ataxia, and postmortem studies have shown frequent involvement of the cerebellum. 1 However, direct neuroimaging evidence of cerebellar damage in patients has rarely been reported. In this article, we describe a patient who.
A decrease in dentate nuclei intensity would indirectly indicate that iron accumulation, and therefore, oxidative stress may play a role in alcoholic cerebellar degeneration. MRI of 45 alcoholics and 44 ageand sex-matched healthy control subjects was performed using a 3D-T1-weighted fast low angle shot (FLASH) echo sequence Cerebellar Degeneration Fast Facts Cerebellar degeneration is the progressive loss of nerve cells in the cerebellum, the part of the brain responsible for balance and muscle coordination. Symptoms of cerebellar degeneration may include an awkward gait, balance difficulties, uncontrolled muscle movements, and slurred speech. Cerebellar degeneration can be cause cerebellar atrophy and alcoholic cerebellar degeneration (p < .01). Cerebellar Sulci Except for the number of vermian sulci in Friedreich's ataxia, there was a significant increase in the number and width of the cerebellar and vermian sulci in all diagnostic categories (Table 1). In comparison with Friedreich's ataxia and alcoholic cerebellar.
Google cerebellar atrophy with NIH or emedicine or wiki to find good articles on the subject. A common cause in our society is long-term alcohol use. The reason the roadside drunk test includes balance and limb control tests (tandem walk, nose-touching) is that acute and chronic, alcohol hits the cerebellum har Brain imaging: magnetic resonance imaging (MRI) or computed tomography (CT) Neuroimaging of the spinal cord. a patient with ataxia may have the cerebellar form of multiple system atrophy (MSA), idiopathic cerebellar degeneration, or a new type of ataxia for which no specific test is yet available. Alcohol use; Anxiety or stress Midline cerebellar degeneration (also referred to as alcoholic cerebellar degeneration) is a component of WKS, but may also occur alone. It causes ataxia of stance and gait with relative sparing of the arms. It has an insidious onset and a subacute or chronic course. Pathologically, there is loss of Purkinje and granular neurons Cerebellar degeneration may precede the discovery of the cancer by weeks to years. Anti-Yo, now called PCA-1 (Purkinje cell cytoplasmic antibody type 1) is a circulating autoantibody that occurs in the serum or cerebrospinal fluid (CSF) of some patients, especially women with breast or ovarian cancer
. Friedreich ataxia. Hemorrhage. Multiple sclerosis. Spinocerebellar degeneration. history and physical examination are sufficient to identify the likely etiology of tremor. However, MRI or CT of the brain should be done if. Tremor onset is acute. Progression is rapid. Focal neurologic signs suggest a. Another possible culprit is long term alcohol use. The blue arrows indicate the dark areas of cerebellar atrophy, where there has been volume loss of the cerebellar folia. There are other causes of cerebellar degeneration, but long term phenytoin and alcohol are two of the most common toxic causes
Magnetic resonance imaging (MRI) findings are normal early in the course of paraneoplastic cerebellar degeneration but can show cerebellar atrophy in advanced cases. [ 25 ] MRI of the brain with contrast is recommended to exclude any structural, demyelinating, vascular, or infectious causes However, there had been considerable interest in alcohol-associated conditions like the Wernicke-Korsakoff syndrome (WKS) and cerebellar cortical degeneration well before, since there were specific clinical syndromes that could be recognized by neurologists (Victor et al., 1959, 1971) and psychiatrists (Wernicke, 1881) Summary: Two cases of pontine infarct with Wallerian degeneration (WD) of the pontocerebellar fibers are described. WD of pontocerebellar fibers, seen bilaterally along the transverse pontine fibers, is more visible in the middle cerebellar peduncles and extends into the white matter of the cerebellar hemispheres. Understanding the anatomy of the white matter and the temporal evolution of this.
Cerebellum (dorsal view) Genetic factors. Sometimes cerebellar ataxia can have a genetic origin. This is known as autosomal dominant cerebellar ataxia, and results from inherited mutations in the form of triplet repeat expansion, in genes SCA1 to SCA37.Triplet repeat expansion refers to a repeated segment of DNA, known as a trinucleotide repeat, that is unstable and interferes with protein. A toxic disorder that is useful to examine the neuropathology of cerebellar degeneration is an alcohol abuse disorder. In a true alcoholic patient, cerebellar degeneration disorders involve Purkinje cells, including the molecular cell layer, with a distinct distribution, predominant in the anterior vermis While alcohol intoxication may cause ataxia, chronic exposure to alcohol and the solvents may result in cerebellar degeneration. Medications which cause cerebellar degeneration and associated.. diagnosed w/cerebellar atrophy from mri due to balance/memory issues.what tests can i expect next, and what are they looking for?44yr.old non-drinker. Alcoholic cerebellar degeneration. Connect by text or video with a U.S. board-certified doctor now — wait time is less than 1 minute! Talk to a doctor now. 24/7 visits Acute cerebellar ataxia of childhood; Acute disseminated encephalomyelitis (ADEM) Miller-Fisher variant of Guillain-Barre syndrome (ataxia, ophthalmoplegia, areflexia) Chronic: Multiple sclerosis; Alcoholic cerebellar degeneration; Phenytoin-induced cerebellar degeneration; Hypothyroidism; Brain Tumor; Paraneoplastic cerebellar degeneration
Review of her MRI Brain revealed mild diffuse cerebellar degeneration but otherwise normal. [neurology.org] A case report and review of the literature. ( 6739288 ) Cavo M....Del Zotto E. 1984 29 Downbeat nystagmus with alcoholic cerebellar degeneration Cerebellar lesion: Signs or Function: Posterior (Flocculo-nodular lobe; Archicerebellum) Eye movement disorders: Nystagmus; Vestibulo-ocular reflex (VOR) Postural and gait dysfunction: Midline (Vermis; paleocerebellum) Truncal & gait ataxia: Hemisphere (Neocerebellum) Limb ataxia: Dysmetria, Dysdiadochokinesis, Intention tremor Dysarthria. from an acquired ataxia, such as alcoholic cerebellar degeneration or paraneoplastic cerebellar degenera-tion. Others have a genetic cause despite negative family history.1-3 In the majority of these patients, however, a genetic or acquired cause of ataxia can-not be identiﬁed suggesting a sporadic degenerative ataxia Background: The mechanisms of cerebellar degeneration attributed to prolonged and excessive alcohol intake remain unclear. Additional or even alternative causes of cerebellar degeneration are often overlooked in suspected cases of alcohol-related ataxia. The objectives of this study were two fold: (1) to investigate the prevalence of gluten
Atypical MRI Findings Atypical MRI findings are represented by symmetric alterations of the cerebellum, ver-mis of cerebellum, cranial nerve nuclei, red nuclei, dentate nuclei, caudate nuclei, spleni-um, and cerebral cortex [12, 18, 20-34] (Figs. 3 and 4). Cerebellar signal intensity alterations are rare in WE, but they hav Outside records showed normal thyroid function tests, positive antithyroid peroxidase antibodies, and a magnetic resonance imaging (MRI) impression suggestive of isolated cerebellar degeneration. Her extensive work-up had also included autoimmune serologies, which returned negative, and nutrition studies that were normal cerebellar atrophy. However, MRI brain revealed no abnormality in our patient. Opportunistic infections were ruled out on CSF examination and MRI. Since patient was occasionally alcoholic, possibility of alcoholic cerebellar degeneration can be considered but neuro imaging in alcoholic cerebellar ataxia demonstrates cerebellar atrophy an
Introduction. Computed tomography (CT) is the primary imaging modality in the investigation of suspected cerebellar degeneration. A case is presented in which an inaccurate clinical and radiological diagnosis of cerebellar degeneration resulted from CT imaging demonstrating loss of cerebellar substance Phenytoin associated Cerebellar atrophy - MRI 28 year old female with chronic seizures on long term phenytoin therapy. MR examination of the brain showing diffuse atrophy of the both lobes of the cerebellum, vermis and the brainstem evidenced by prominent cerebellar foliae, pre pontine and CP angle cisterns cerebellar atrophy and the presence of alcohol abuse, substance abuse, measures of dementia or cerebellar function, or with CD4+T-cell counts or viral load. Average hand-traced contours at midline showed that the posterior cerebellar vermis in HIV was contracted by approximately 2.5mm relative to the mean contour in controls. Consisten
Paraneoplastic Cerebellar Degeneration: A Rare but Important Consideration A 57 year old, non smoker, non alcoholic, female presented with one year history of unsteadiness of gait, tremulousness of both upper Her Magnetic Resonance Imaging (MRI) brain showed diffuse cerebellar atrophy. After excluding common causes o Rosenbloom MJ, Pfefferbaum A. Magnetic Resonance Imaging of the Living Brain: Evidence for Brain Degeneration Among Alcoholics and Recovery With Abstinence. Alcohol Res Health. 2008;31(4):362-76. Zahr NM. Structural and Microstructural Imaging of the Brain in Alcohol Use Disorders
Background Alcohol-related cerebellar degeneration is one of the commonest acquired forms of cerebellar ataxia. The exact pathogenic mechanisms by which alcohol leads to cerebellar damage remain unknown. Possible autoreactive immune mediated mechanisms have not been explored previously. In this study, we aim to investigate the potential role of alcohol-induced immune mediated cerebellar. The relationship between alcoholic cerebellar degeneration and cognitive and emotional functioning. Neuroscience and biobehavioral reviews 2008;32:466-485. [PubMed: 17919727] NIH-PA Author Manuscript Fuster J. Synopsis of function and dysfunction of the frontal lobe This part is called the vermis of the cerebellum). So in alcoholic cerebellar degeneration we see vermian cerebellar atrophy in CT scan and MRI scans and also grossly if an autopsy is carried out). So how does vermian atrophy present clinically? Patients with alcoholic cerebellar degeneration have problems with gait and balance INTRODUCTION. Cerebellar ataxia is a common finding in patients seen in neurologic practice and has a wide variety of causes .Although cerebellar degeneration may be chronic and slowly progressive, acute cerebellar swelling due to infarction, edema, or hemorrhage can have rapid and catastrophic effects and is a true neurologic emergency A number of conditions can lead to cerebellar degeneration, and some of these might also affect other portions of the brain and spinal cord. There are a number of neurological symptoms to look out for. Cerebellar degeneration has multiple causes. It may be related to chronic alcohol abuse or inherited gene mutations
The phrases cerebellar degeneration and spinocerebellar degeneration are used to describe changes that have taken place in a person's nervous system; neither term constitutes a specific diagnosis. Cerebellar and spinocerebellar degeneration have many different causes Alcohol-Related Neurologic Disease: Definition Alcohol, or ethanol, is a poison with direct toxic effects on nerve and muscle cells. Depending on which nerve and muscle pathways are involved, alcohol can have far-reaching effects on different parts of the brain, peripheral nerves, and muscles, with symptoms of memory loss, incoordination,. In the MSA-C form, there is predominance of cerebellar symptoms with olivopontocerebellar atrophy. MRI shows T2 hyperintensity in the pontocerebellar tracts, resulting in a hot cross bun sign in the pons and disproportionate atrophy of the cerebellum and brainstem . Figure 32a Alcoholic cerebellar degeneration. Friedreich ataxia. Hemorrhage. Multiple sclerosis. Spinocerebellar degeneration. history and physical examination are sufficient to identify the likely etiology of tremor. However, MRI or CT of the brain should be done if. Tremor onset is acute. Progression is rapid. Focal neurologic signs suggest a. alcoholism and acute and chronic alcohol consumption produce profound impairments in cerebellar function. In autopsy studies, approximately 40 percent of alcoholics show signs of cerebellar degeneration (Torvik and Torp, 1986). This can be recognized in vivo using MRI (Pfefferbaum and Rosenbloom, 1993; Sullivan, 2003) and the changes ar
Alcoholic cerebellar degeneration (ACD) is a chronic cerebellar disease that occurs mainly in middle-aged men with a history of chronic alcohol abuse. Degeneration affects the cerebellar cortex of the anterior superior vermis and adjacent hemispheres, parts of the cerebellum that mainly receive spinal afferents Brain MRI findings in AHD with Ataxia-Plus Syndrome. (A) High signal lesion on T2-weighted image and (B) low signal lesion on T1-weighted image in the middle cerebellar peduncles Reproduced with permission from Ishii K et al. 75 AHD, Acquired Hepatocerebral Degeneration; MRI, Magnetic Resonance Imaging Alcoholic cerebellar degeneration Alcoholic cerebellar degeneration (ACD) is a chronic cerebellar disease that occurs mainly in middle-aged men with a history of chronic alcohol abuse. Degeneration aﬀ ects the cerebellar cortex of the anterior superior vermis and adjacent hemispheres, parts of the cerebellum tha
In short, this condition is called cerebellar degeneration. Cerebellum Anatomy and Function. The cerebellum is a part of the brain located just above the brain stem and below the occipital lobes. The term is derived from a Latin word meaning 'little brain'. Gross Points Magnetic Resonance Imaging (MRI) of Cerebral and Cerebellar Veins using Other Contrast, Unenhanced and associated alcoholism (F10.-); Alcoholic cerebellar ataxia; Alcoholic cerebellar degeneration; Alcoholic cerebral degeneration; Alcoholic encephalopathy; Dysfunction of the autonomic nervous system due to alcohol. ICD-10-CM Diagnosis Code.
Alcoholic cerebellar degeneration. Definition: degeneration of cerebellar vermis due to chronic alcohol use; Clinical features . Unsteady gait; Truncal ataxia; Gaze-evoked nystagmus; Diagnostics . CT or MRI: atrophy of the cerebellar vermis; Marchiafava-Bignami diseas Magnetic resonance imaging (MRI) of the brain was performed, and T2-weighted and fluid-attenuated inversion recovery (FLAIR) images showed focal hyperintensity and expansion of both medullary olives Hypertrophic olivary degeneration after resection of a cerebellar tumour Alcoholic cerebellar degeneration (ACD) is one of the most common neurological complications in alcoholics. As far as we know, however, only four Japanese autopsy cases of ACD have been reported, and only limited clinicopathological data on this disease are now available in Japan. The aims of this study were: (i) to examine the clinicopathological correlation of six Japanese autopsy cases of. Mary McMahon Date: February 23, 2021 Individuals with damage to the cerebellum may experience balance difficulties.. Cerebellar atrophy is a degeneration of the cerebellum, a section of the brain responsible for balance, voluntary muscle movements, and posture. People with damage to the cerebellum can experience symptoms like unsteady gait, poor muscle control, and trouble speaking or swallowing
MRI - CT scans are not good at looking at the posterior cranial fossa Paraneoplastic cerebellar syndrome Alcoholic cerebellar degeneration Sclerosis (MS) Tumour (posterior fossa SOL) What malignancies are associated with paraneoplastic cerebellar degeneration? Cancers of the ovary, lung, breast, uterus and Hodgkin's lymphoma or MRI. In patients with ataxia secondary to alcohol abuse, imaging might reveal degen - eration of the cerebellar vermis. •Perform laboratory tests, such as inflammatory markers, vitamin levels, and thyroid function testing to detect possible toxic-metabolic or inflammatory causes. Alcohol-induced ataxia can be diagnose Parkinsonism in AHD may be related to the MRI changes on T1‐weighted images observed in the globus pallidus and other structures of the basal ganglia. Ataxia and other cerebellar signs could be related to the hyperintensities found in brainstem and cerebellum, rather than being a consequence of alcoholic cerebellar degeneration an acquired ataxia, such as alcoholic cerebellar degen-eration or paraneoplastic cerebellar degeneration. Others have a genetic cause despite negative family his-tory.1-3 In the majority of these patients, however, a genetic or acquired cause of ataxia cannot be identiﬁed suggesting a sporadic degenerative ataxia Magnetic resonance imaging (MRI) findings are normal early in the course of paraneoplastic cerebellar degeneration but can show cerebellar atrophy in advanced cases.  MRI of the brain with contrast is recommended to exclude any structural, demyelinating, vascular, or infectious causes
Alcohol induced tissue injury to the CNS leading to cerebellar degeneration may also involve immune mediated mechanisms, including sensitization to gluten. The team is calling for role of gluten in ataxia to be studied further, to determine the exact mechanism, and the extent of gluten's impact on ataxia patients Ataxia arising after age 40 years is less likely to be hereditary and may be an acquired ataxia, for example, of toxic origin (such as alcohol-induced cerebellar degeneration). Individual types of ataxia can be diagnosed by molecular-genetic testing, imaging studies, or laboratory analysis Cerebellar ataxia and cerebellar degeneration are common to all types, but other signs and symptoms, as well as age of onset, differ depending on the specific gene mutation. Episodic ataxia (EA). There are eight recognized types of ataxia that are episodic rather than progressive — EA 1 through EA 7, plus late-onset episodic ataxia Hi There ! I'm Rajesh A World to be Shared & Learnt Blog Of the People; For the People; By the People Of Service @ Viavi Solutions, Regional Vice President, Asia Pacifi
Cerebral atrophy can be caused by injury or disease. Cerebellar atrophy is a degeneration of the cerebellum, a section of the brain responsible for balance, voluntary muscle movements, and posture. It may be seen during a magnetic resonance imaging (MRI) scan of the brain Neoplasms associated with paraneoplastic cerebellar degeneration (PCD) are adult onset and more prevalent in females. A common clinical presentation is a middle-aged female with or without a comorbid condition who presents with mild dizziness and nausea followed by vertigo and nystagmus that may suggest a peripheral vestibular problem
Chronic alcohol abuse and long-term usage of antiepileptic medications, most commonly phenytoin, also result in decreased FDG uptake throughout the cerebellum. 2,3 The typical correlating finding on cross-sectional imaging is diffuse atrophy with prominence of the cerebellar sulci and ex vacuo expansion of the fourth ventricle. The differential. McLain LW et al. Cerebellar degeneration due to chronic phenytoin therapy. Ann Neurol 1980;7:18-23. Benabou R et al. Progressive irreversible ataxia after long-term phenytoin therapy. Neurology 1995;45(suppl4):A368. Munoz-Garcia D et al. Truncal ataxia in chronic anticonvulsant treatment. Association with drug-induced folate deficiency 159. MRI ï¿½ Hippocampus, mesial temporal sclerosis: 160. MRI ï¿½ Post-seizure hyperintensity: 161. Laminar necrosis: 162. Carbon monoxide poisoning: 163. Wilson disease (hepatolenticular degeneration) 164. Alzheimer type II astrocytes: 165. Alcoholic cerebellar degeneration: 166. CT ï¿½ Cerebellar atroph