Walther J U
Fortschr Neurol Psychiatr. 1982 Aug;50(8):258-66. doi: 10.1055/s-2007-1002268.
The group of cerebellar ataxias in adults represents a collection of very heterogeneous causes, pathogeneses, morphological changes and - as far as the hereditary types are concerned - heredity. Different modes of inheritance (dominant or recessive) signify different aetiologies to the geneticist. However, genetic heterogeneity is often associated with similarities of the phenotypes concerned. A decisive descriptive differentiation is that between a) degenerative changes of the cerebellum and the pertaining paths and b) cerebellar ataxias with associated non-neural changes. Meanwhile consensus has been reached regarding the gross anatomical classification of cerebellar ataxias into a) olivopontocerebellar atrophies ("cerebellopetal") b) primary cerebellar parenchymatrophies ("cerebellofugal"). A more reliable classification of the monogenic types will become possible in the near future with the help of the genetic marker of the HLA haplotypes. A comprehensive classification of non-hereditary and hereditary cerebellar ataxias based on clinical, pathologico-anatomical and genetic parameters is presented and summarized in Table 4.
成人小脑性共济失调是由多种非常不同的病因、发病机制、形态学改变以及(就遗传类型而言)遗传方式所构成的集合。不同的遗传模式(显性或隐性)对遗传学家来说意味着不同的病因。然而,遗传异质性常常与相关表型的相似性相关联。一个决定性的描述性区分在于:a)小脑及其相关通路的退行性改变与b)伴有相关非神经改变的小脑性共济失调之间的区别。与此同时,对于小脑性共济失调的大体解剖学分类已达成共识,即分为:a)橄榄脑桥小脑萎缩(“向心性小脑萎缩”)b)原发性小脑实质萎缩(“离心性小脑萎缩”)。借助HLA单倍型的遗传标记,在不久的将来对单基因类型进行更可靠的分类将成为可能。基于临床、病理解剖学和遗传学参数的非遗传性和遗传性小脑性共济失调的综合分类见表4。