Post-Heat Stroke Cerebellar Atrophy

There are a few cases reported of cerebellar involvement following heat stroke worldwide. We present a rare case of cerebellar atrophy following heat stroke in India. A 25-year-old male soldier in the Indian army presented with giddiness followed by loss of consciousness after extreme exertion during a prolonged march past in hot and humid climate. Clinical examination revealed tachycardia and hyperpyrexia (106° F). All preliminary investigations were normal. With a diagnosis of heat stroke, rapid cooling was applied with external cooling chamber and intravenous fluids were given to rehydrate the patient. Antipyretics were given per rectally to bring down the temperature. 7 days later, the patient regained consciousness but developed incoordination of movement of all four limbs and slurring of speech. MRI brain revealed diffuse cerebellar atrophy involving the vermis and both lobes with prominent cerebellar foliae. 6 months following rehabilitation services, the patient continued to have incoordination of the movement of all the limbs and slurring of speech.