Neurogenetic disorders, antiseizure medications, and seizures can impair cerebellar functions, causing sensorimotor, cognitive and affective disorders. Chronic epilepsy can impair cerebellar functions, with maximal involvement in posterior non-motor lobules, which may contribute to epilepsy progression and treatment resistance. Low grade cerebellar lesions can cause hemifacial motor seizures in early life, which respond to lesion resection, not antiseizure medications.