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Isolated cerebellar atrophy

Case contributed by Servet Kahveci
Diagnosis almost certain

Presentation

An epileptic patient with chronic phenytoin use.

Patient Data

Age: 25 years
Gender: Male
mri

Diffuse cerebellar atrophy inappropriate with patient's age due to chronic phenytoin use.

Note the normal cerebral hemispheres.

Case Discussion

Phenytoin induced cerebellar atrophy occurs after prolonged exposure to phenytoin, usually for the treatment of epilepsy. 

Radiologic features of isolated cerebellar atrophy:

  • diffuse cerebellar volume loss
  • ex-vacuo dilatation of the fourth ventricle
  • prominence of the cerebellar folia
  • normal cerebral hemispheres

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