A Study on Selective Cerebellar Degeneration Following ,β-Fluorethyl Acetate Poisoning

Abstract

This is to report clinical and radiological findings in 7 patients with selective cerebellar degeneration following ,B-fluoroethyl acetate intoxication. ,B-Fluoroethyl acetate, an ethyl ester of fluoroacetate which is a metabolic inhibitor of Krebs cycle is used as a rodenticide. Following initial stage of coma from intoxication, the patients woke up to show selective cerebellar dysfunction, often so severe as not to be able to sit or stand unsupported. They improved gradually over several months to years with variable degrees of residual cerebellar dysfunction. Gait disturbance and dysarthria were the most prominent and persistent factors of the cerebellar dysfunction, whereas mild nystagmus was rarely seen. Cognitive function was not impaired. Cerebellar atrophy became noticeable on CT and MRI 4 weeks after poisoning, and progressed over time even with clinical improvement. Cerebellar degeneration contrasts with pallidal degeneration following carbon monoxide poisoning. ,B-Fluoroethyl acetate may be selectively toxic to the cerebellum.