Hemicerebellitis can drive handedness shift

Background: Hemicerebellitisis a rare acquired condition, typical of the pediatric age. A residual switched handedness may develop after remission of acute cerebellar symptoms. Case presentation: Herein we describe a motor functional MRI studyperformed in a 35-year old girl who had switched to left-handedness after acute right hemicerebellitis in childhood. During left hand tapping, we observed activation in the right primary sensori-motor cortex, right supplementary motor area and left superior cerebellum. During right hand tapping bilateral activations of primary sensori-motorcortex and superior cerebellum including the vermis and activation of the right supplementary motor area were observed. We speculate that during right hand tapping both the ipsilateral and contralateralpre-central gyri and the ipsilateral cerebellum would be engaged in order to recover the tapping internal model of action. From this perspective the ipsilateral pre-central gyrus might serve as are transmission station of information from the healthy cerebellum to the contralateral pre-central gyrus. Conclusion: Selective damage of the right half of the cerebellum due to hemicerebellitis in childhood can drive shift of lateralized hand functions in the cerebrum.