Cerebellar Disorders

Front 1

The main functions of the cerebellum are coordination of:

Back 1

1. somatic motor activity
2. regulation of muscle tone
3. maintenance of equilibrium

Front 2

Afferent Input:

Back 2

-from the stretch receptors(gradual alteration of muscle tension for equilibrium and posturing)

Front 3

Each movement requires:

Back 3

Coordination or synergy of movement:
-agonists(contract)
-antagonists(relax)
-others stabilize the joints

Front 4

Clinical Findings

Back 4

1. Hypotonia
2. Ataxia
3. Cerebellar dysarthria
4. Intention Tremor
5. Eye movements(usually nystagmus)

Front 5

Hypotonia

Back 5

-a decrease in tone in response to stretch(can freely move the individual bc there is no response to stretch)
-typically seen in hemispheric lesions
-low tone

Front 6

Ataxia

Back 6

-broad term that refers to issues with smooth performance of voluntary acts
-includes abasia, dysmetria, dysdiadochokinesis, impaired rebound, and titubation

Front 7

Abasia

Back 7

-your stance
-patients with cerebellar disorders need a wide base o stand and walk

Front 8

Dysmetria

Back 8

-abnormal excursions in movement; an overshoot of movement
-test for this with a finger-to-nose test
*she stressed this symptom

Front 9

Dysdiadochokinesis

Back 9

-impaired rapid alternating movements
-ask pt to rapidly flip their hand back and forth

Front 10

Impaired Rebound

Back 10

-this is when pt CANNOT check their response, and end up overshooting or undershooting their response
-test by pulling on pt's arm and asking them to resist you; when you let go of the arm, the pt should be able to check their movement not long after it is released

Front 11

Titubation

Back 11

bobbing of the head

Front 12

Cerebellar Dysarthria

Back 12

-abnormalities in articulation and PROSODY
-prosody is the emotional content of behavior
-indicative of a left cerebellar lesion that interferes with right cerebral hemisphere connections
-slow staccato or scanning speech
-uneven phonation

Front 13

Non-motor functions of the cerebellum

Back 13

1. Sensory discrimination
2. Attention/personality
3. Memory
4. Verbal learning
5. Speech
-result from parallel circuits within the cerebello-cortico pathways linking the lateral cerebellar hemispheres with non-motor cortical areas

Front 14

Cerebellar Cognitive Affect Syndrome(CCAS)

Back 14

Describes deficits in:
-executive functioning(planning, set-shifting, abstract reasoning, working memory)
-spatial cognition (visual spatial cognition and memory)
-linguistic abilities
-personality changes

Front 15

Cerebellar Mutism Syndrome(CMS)

Back 15

-unique postoperative syndrome typically arising 1 to 2 days after resection of a midline posterior fossa tumor
-combo of severe dysarthria and cognitive component of speech
-components of CCAS may also be seen
-we dont have a way to predict who will get it

Front 16

Outcome of CMS

Back 16

-functional speech gradually returns over months to years
-emotional lability improves over weeks to months
-ataxia persists in 78% to 90% of pts with moderate severe cerebellar mutism at 2 yrs
-CCAS often persists

Front 17

Cerebellar Principles

Back 17

1. Hemispheric lesions cause IPSILATERAL signs*
2. Midline lesion causes trunk and gait instability (midline problems)*
3. Disturbances are due to lack of motor control and regulation

Front 18

Localization

Back 18

-different portions of the cerebellum are responsible for different outputs and this can help you localize the problem when examining a patient

Front 19

Damage to the Vestibulo-cerebellum would likely result in:

Back 19

issues with equilibrium and gait

Front 20

Damage to the Spino-cerebellum would likely result in :

Back 20

issue with tone and movement regulation

Front 21

Damage to the cerebro-cerebellum would likely result in:

Back 21

slow movement initiation/tremor/spatial

Front 22

Damage to the vermis would likely result in:

Back 22

-wide based stance and gait---staggering
-little or NO limb ataxia
-Medlloblastoma was given as a case in class(tumor on midline/vermis caused in equilibrium when feet were close together)

Front 23

Hemispheric damage would likely result in :

Back 23

-ipsilateral issues
-especially evident on fine motor movements

Front 24

Lupus

Back 24

-an inflammatory, autoimmune disease that presents with sudden onset of weakness in speech and other difficulties like writing, doing the finger-to-nose test, eye movements and speech
-MRI shows white spots that shouldn't be there