Abstract
Cerebellar agenesis is an extremely rare condition in which patients show minute cerebellar tissue, usually corresponding to remnants of the lower cerebellar peduncles, anterior vermal lobules, and flocculi. Clinical presentation of cerebellar agenesis may cover a broad phenotypic spectrum of disabilities including not only motor disorders but also cognitive abilities, language disabilities, and affective disorders. The severity and range of motor, cognitive, and psychiatric impairments appears to be correlated with the earliness, localization, and extent of the agenesis of the cerebellum. Patients with congenital malformations display, for example, a more severe and less specific impairment than patients with acquired cerebellar lesions in adult life. The most severe clinical picture is one of patients with involvement of the phylogenetically most ancient structures (complete or partial cerebellar vermis agenesis) as they display severe pervasive impairments in social and communication skills (autism or autistic-like behavior) and in behavior modulation (self-injury and aggressiveness) and marked delays in language acquisition, especially in language comprehension. On the contrary, when the lesions are confined to phylogenetically more recent structures such as cerebellar hemispheres, the clinical picture is characterized by mild cognitive impairment or borderline IQ, good social functioning, and context adjustment abilities with a more favorable prognosis.
In conclusion, it is possible to argue that cerebellar agenesis, in spite of having an extraordinary neuroradiological picture, is a clinical condition compatible with a productive although limited life, especially if the affected person has the opportunity to undergo a rehabilitation program at an early stage of his life.
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Romaniello, R., Borgatti, R. (2020). Cerebellar Agenesis. In: Manto, M., Gruol, D., Schmahmann, J., Koibuchi, N., Sillitoe, R. (eds) Handbook of the Cerebellum and Cerebellar Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-97911-3_84-2
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