Cerebellar Disorders in Children – Chapter 41: Toxic Agents (ebook)


Chapter 41 – Toxic Agents

Andrea Poretti and Eugen Boltshauser

It is well known from clinical observations in adults that the cerebellum is vulnerable to a large range of toxic agents (Timmann and Diener 2000; Manto 2010).The most relevant toxic agents are alcohol, several drugs such as phenytoin, antineoplastic drugs, and lithium, heavy metals (mercury, lead, and thallium), several ‘industrial’ organic solvents, insecticides, herbicides, heroin, and cocaine. Chronic intoxication (overuse) may lead to a permanent ataxic syndrome, often with evident cerebellar atrophy on neuroimaging (e.g., alcohol consumption and chronic phenytoin treatment). Because of different potential exposure and consumption of toxic agents, the problem of cerebellotoxic agents is fortunately small in the pediatric age, and is examined in this chapter.

Please note that Chapters 40-42 are also available in Part 9: Extrinsic Insults.

About the Complete Book:

This clinically orientated text by an international group of experts is the first definitive reference book on disorders of the cerebellum in children. It presents a wealth of practical clinical experience backed up by a strong scientific basis for the information and guidance given. The first part sets out the theoretical underpinnings of cerebellar disorders. This is followed by sections on clinical conditions grouped according to common characteristics such as aetiology and symptomatology. The descriptions of the clinical conditions each systematically cover, as appropriate, epidemiology, prevalence, diagnostic criteria, clinical features (including course and prognosis), pathophysiology, genetics, investigations, differential diagnosis, and management and treatment. This book will be an invaluable resource for all those caring for children affected by cerebellar disorders, including malformations, genetic and metabolic disorders, acquired cerebellar damage, vascular disorders and acute ataxias. This comprehensive reference text on cerebellar disorders in children includes chapters on cerebellar development, prenatal cerebellar imaging, imaging of the posterior fossa, with coverage of a broad range of malformations, genetic and metabolic disorders involving the cerebellum, prenatal cerebellar disruptions (as related to prematurity), vascular disorders, tumors and paraneoplastic syndromes, as well as acute ataxia and trauma to the posterior fossa. Numerous checklists are provided to assist in the differential diagnosis of clinical signs and neuroimaging findings.

Paediatric neurologists, paediatricians, neurologists, developmental paediatricians, neuroimaging specialists, geneticists, neonatologists

Clinics in Developmental Medicine No. 191-192