Toxic Agents

Abstract

Cerebellum is vulnerable to intoxication and poisoning, especially in elderly patients and in patients with structural lesions. Purkinje neurons are the main target of cerebellotoxic agents. The most common toxic agent is ethanol. Cerebellotoxic drugs include antiepileptics, antineoplastics, lithium salts, and heroin. Regarding environmental factors, chronic exposure to heavy metals, benzene derivatives, and hyperthermia cause a cerebellar syndrome. Recently, deposits of gadolinium (Gd), a heavy metal of the lanthanide group, have been described mainly in dentate nuclei and globus pallidus following repeated administration of linear Gd-based contrast agents (GBCAs). Both the mechanism of these deposits and their clinical consequences are unknown. Cerebellotoxicity should be listed in the differential diagnosis of cerebellar ataxia of unknown origin.