Overview Signs and symptoms of cerebellar disease presents on the same side (ipsilateral). Symptoms and signs consist of gait impairment, unclear (“scanning”) speech, visual blurring due to nystagmus, hand in-coordination, and tremor with movement.
| Remember |
| CAUSES OF CEREBELLAR DISEASE BASED ON ONSET | ||
| Acute | Subacute | Chronic |
| Drugs (phenytoin, lithium) | Alcohol | Chronic infection |
| Alcohol intoxication | Malnutrition (Vitamin B12 and B1 deficiency | Friederichs ataxia |
| Paraneoplastic syndrome | Hypothyroidism | |
| Hyponaturaemia | ||
| CAUSES OF CEREBALLAR DISEASE BASED ON LOCATION | |||
| Unilateral | Bilateral | Midline | Vermis |
| Space occupying lesion | Drugs (phenytoin) | Paraneoplastic Syndrome | Alcohol |
| Ischaemia | Alcohol | ||
| Multiple sclerosis | Friederichs ataxia | ||
| Trauma | Hypothyroidism | ||
| Large space occupying lesion | |||
| Multiple Sclerosis | |||
| Trauma | |||
| Frederichs ataxia is a autosomal recessive ataxia, comprising one-half of all hereditary ataxias. Two forms classic (frataxin) and association with vitamin E deficiency. |
Cerebellar Examination
General
Head
Arms and legs
Special tests
| Side note There are many connections between the cerebellum and the parietal and frontal lobes of the brain and thus explains the clinical presentation that is associated with cerebellar disease |
Pathways in the CNS
Pyramidal Pathways (through medulla)
Extrapyramidal Pathways
Cerebellar Pathway
| CLINICAL DIFFERENCES BETWEEN THE CENTRAL NERVOUS SYSTEM PATHWAYS | ||||
| Clinical signs | Pyramidal | Extrapyramidal | Cerebellar | Functional |
| Power | Weak | No weakness | No weakness | Give-way weakness |
| Wasting | None (overtime no use maybe) | None | None | None |
| Tone | Spastic increase | Rigidity | Normal/reduced | Normal |
| Reflexes | Increased | Normal | Normal | Normal |
| Plantar response | Extensor | Flexor | Flexor | Normal |
| Coordination | Reduced by weakness | Normal but slow | Impaired | Normal (laborious) |
