A CASE OF MARKED CEREBELLAR ATROPHY IN A WOMAN WITH ANOREXIA-NERVOSA AND CEREBRAL ATROPHY AND A REVIEW OF THE LITERATURE

While cerebral atrophy has been shown in patients with anorexia nervos a, cerebellar atrophy has never been reported in these patients. We re port a case of cerebra! atrophy with marked cerebellar atrophy in a 20 -year-old woman with anorexia nervosa admitted to our hospital for sev ere weight loss. Neuroradiological examinations of the patient showed morphological brain alteration without focal parenchymal lesions. Cran ial computerized tomography (CCT) showed an enlargement of the externa l cerebrospinal fluid spaces, especially those close to the cerebellar cistern. A brain magnetic resonance imaging (MRI) study confirmed the results of the CCT and dynamic single-photon emission tomography (d-S PECT) showed a reduced perfusion of the left brain areas. The reported case shows that some forms of anorexia nervosa have a concomitant pre sence of cerebral and cerebellar morphological anomalies. At present, it is not possible to demonstrate the whole correlation between the im aging reports and the clinical or neurological symptomatology. Some fo rms of brain alteration could be secondary to undernutrition; on the o ther hand, cerebral and cerebellar atrophy and eating disorders are fa r from clear and may also be an expression of an unknown common denomi nator. (C) 1998 by John Wiley & Sons, Inc.