Sporadic late-onset cerebellar degeneration occurs as part of multiple system atrophy.
Onset is usually after the age of 50 years and follows a benign course. Clinical features are variable, ranging from a pure cerebellar ataxia with preservation of upper limb function to a pattern more typical of olivopontocerebellar degeneration.
CT reveals cerebellar and/or brain-stem atrophy. Mass lesions are absent.
It is important to exclude cerebellar degeneration secondary to alcohol, hypothyroidism, drugs, e.g. phenytoin etc.
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