Substance use: alcoholic cerebellar degeneration: practice question

A Psychiatry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Psychiatry · Substance use: alcoholic cerebellar degeneration

Sample item

A 52-year-old man with 25 years of heavy drinking has a slowly progressive wide-based, unsteady gait. Heel-to-shin testing is markedly abnormal, while arm coordination and speech are relatively spared. What is the typical pathological site?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Atrophy of the anterior superior cerebellar vermis

Alcoholic cerebellar degeneration is caused by loss of Purkinje cells, mainly in the anterior and superior vermis. Because the vermis controls gait and trunk, the legs are affected much more than the arms, and speech is often spared.

Option by option

  • A. Degeneration of the corpus callosum

    Callosal degeneration characterises Marchiafava-Bignami disease, with dementia and interhemispheric disconnection.

  • B. Haemorrhagic lesions in the mamillary bodies

    Mamillary body lesions belong to Wernicke-Korsakoff syndrome, which affects memory and eye movements.

  • C. Demyelination of the basis pontis

    Pontine demyelination follows rapid sodium correction and causes quadriparesis.

  • D. Atrophy of the anterior superior cerebellar vermis (correct)

    Correct. Vermian Purkinje cell loss explains the truncal and gait ataxia with relatively preserved arm function.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Psychiatry question

What is the answer to this Psychiatry question?

The best answer is D, Atrophy of the anterior superior cerebellar vermis. Alcoholic cerebellar degeneration is caused by loss of Purkinje cells, mainly in the anterior and superior vermis.

Why is "Degeneration of the corpus callosum" not the answer?

Callosal degeneration characterises Marchiafava-Bignami disease, with dementia and interhemispheric disconnection.

Why is "Haemorrhagic lesions in the mamillary bodies" not the answer?

Mamillary body lesions belong to Wernicke-Korsakoff syndrome, which affects memory and eye movements.

Why is "Demyelination of the basis pontis" not the answer?

Pontine demyelination follows rapid sodium correction and causes quadriparesis.

What concept does this question test?

It tests Substance use: alcoholic cerebellar degeneration in Psychiatry. Because the vermis controls gait and trunk, the legs are affected much more than the arms, and speech is often spared.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Substance use: alcoholic cerebellar degeneration?

Learn each diagnosis by its core features and its first-line treatment. Then use the flashcards and the other Psychiatry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.