Endocrine Disorders

Abstract

Cerebellum is vulnerable to hormonal disturbances. The main endocrine disorders associated with cerebellar ataxia are thyroid diseases. Both hypothyroidism and hyperthyroidism can induce cerebellar symptoms in children and in adults. In most instances, cerebellar deficits may be reversible with hormonal replacement. Patients with impaired parathyroid hormone signaling may also exhibit cerebellar ataxia, including hypoparathyroidism, pseudohypoparathyroidism, and hyperparathyroidism. Diabetes (diabetes mellitus or diabetes insipidus) may also be combined with cerebellar deficits, sometimes in a context of a complex metabolic inherited disorder. There may be no direct causal association between the endocrine disturbance and cerebellar deficits in this case. The workup of cerebellar ataxia of undetermined cause should include detailed hormonal investigations. In particular, thyrotropin hormone (TSH) and free T4 levels should be determined in all ataxic patients, followed by additional hormonal investigations if necessary.