What does alcohol do to the cerebellum?

Alcoholism has the potential to cause quite a diverse range of neurological sequelae, but it is often unclear how much of this is due to (i) a direct toxic effect from alcohol versus (ii) a coexisting thiamine deficiency, which is common is alcoholism.

Nonetheless, one of the regions the alcoholism seems to target is the cerebellum, where it is probably the commonest cause of an acquired cerebellar ataxia. As you'd expect from its cause, males are predominantly affected, and the condition requires years of heavy drinking - it isn't an acute intoxication state.

Although all the cells in the cerebellum take a hit, the worst affected are the Purkinje cells in the vermis. Knowing this, and having read the previous post, you can pretty much work out what the symptoms are. And you'd be right! According to the (terse) textbook^* in front of me, "ataxia of gait with lower limb inco-ordination predominates. The upper limbs are spared. Nystagmus is rarely present. Cerebellar dysarthria is usually mild."

What's the prognosis? It's hard to say. Sometimes one makes a full recovery (if alcohol is stopped and nutrition improved), sometimes the conditions stabilises, and sometimes it is progressive. (Yes, I know that pretty much covers all the options, but still.)

^* "Neurology and Neurosurgery Illustrated", 4th edn., Lindsay and Bone