5 ATAXIC Flashcards
Ataxia: Site of Lesion
• Cerebellum or cerebellar nuclei pathway
The cerebellum is involved in ___ learning and it may have a ___ component
motor, cognitive
Ataxia results in the reduction in control of: (5)
Reduction in control of • Rate • Range • Force of motor act • Coordination • Integration of sensory and motor information
There are more neurons in the ___ than cortex
cerebellum
Ataxia: Characteristics (15)
- Nystagmus
- Inaccuracy
- Disturbed righting reflex
- Equilibrium deficit
- Gait disturbance
- Coordination problems
- Overshoot
- Slow initiation
- Irregular DDK
- Dysrhythmia
- Hypotonic
- Clumsy
- Intention tremor with increase at termination of movement
- Tremor at rest (essential tremor)
- Random errors in target contact
A key indicator for ataxia is ___.
DDK - diadochokinesis
Define: Dysmetria
Cerebellar disorder resulting in poor eye-hand coordination, overshooting movements
___ can be mistaken for __ __.
Discoordination, essential tremors
[T/F] Intention tremor - The amplitude of an intention tremor increases as an extremity approaches the endpoint of deliberate and visually guided movement.
True
Essential tremor is __ times more prevalent in Parkison’s.
8
Ataxic Disarthria: Degenerative Diseases (3)
- Friedereich’s ataxia
- Olivopontocerebellar atrophy (OPCA)
- Multiple Sclerosis
Friederich’s Ataxia (4)
- Inherited, Autosomal recessive
- Begins pre-adolescent
- 15 year course to wheelchair
- Death around 35 years due to cardiac issues
Friederich’s Ataxia: Characteristics (5)
- Ataxia
- Sensory disturbance
- Spasticity
- LMN weakness
- Extrapyramidal features including dystonia, chorea
Define: Dystonia
A neurological movement disorder syndrome in which sustained or repetitive muscle contractions result in twisting and repetitive movements or abnormal fixed postures
Define: Chorea
a neurological disorder characterized by jerky involuntary movements affecting especially the shoulders, hips, and face
Define: Extrapyramidal Tract (4)
- Neural network, part of motor system
- Originates in brain stem, carries motor fibres to spinal cord
- Responsible for involuntary and automatic control of musculature, including muscle tone, balance, posture, and locomotion
- Four tracts: Vestibulospinal, reticulospinal, rubrospinal, tectospinal
Olivoponteocerebellar Atrophy (OPCA): Etiology
Autosomal dominant
Type of multiple systems atrophy disease
Degeneration of pontine nuclei
Arcuate fasciculus of cortex (temporal to frontal)
olivary nuclei (MSO and LSO)
Middle cerebellar peduncles
Cerebellum
Sometimes also basal ganglia, cerebral cortex, spinal cord, peripheral nerves
Olivoponteocerebellar Atrophy (OPCA): Characteristics (2)
- Progressive ataxia of gait
* Progressive ataxic dysarthria
Multiple Sclerosis is usually accompanied by __ dysarthria.
mixed
Paroxysmal ataxic dysarthria (PAD):
associated with MS
• Brief episodes of ataxic dysarthria
- Accompanied by limb or visual problems
- 5-30 seconds each
Vascular Disorders that may result in Ataxic Dysarthria (3)
- Hemorrhage
- Arteriovenous malformations resulting in hemorrhage
- Ischemic Infarct
Define: Thrombosis
Blood clot preventing flow of blood through circulatory system
Define: Ischemic Infarct
Stroke caused by lack of oxygen due to blood clot or obstruction
Define: Arteriovenous Malformation (AVM)
Abnormal connection btw arteries and veins
Common locations for an Ischemic Infarct: (3)
- Posterior inferior cerebellar artery at level of medulla
- Anterior inferior cerebellar artery at level of pons
- Superior cerebellar artery at level of midbrain
Define: Neoplasm
a new and abnormal growth of tissue, can become cancerous
Characteristics of Cerebellopontine angle tumors (4)
- Meningiomas usually
- Results in pressure on middle cerebral peduncle, dentate nucleus, posterior cerebellar lobes
- Often includes cranial involvement of V, VI, VIII, VIII, X
- May be ataxic, flaccid, spastic
Neoplasms can involve cranial nerves _, _, _, _, and _.
V - Trigeminal VI - Abducens VII - Facial VIII - Vestibulocochlear X - Vagus
Neoplasms that can result in Ataxic Dysarthria: (3)
- Cerebellopontine angle tumors
- Tumors in fourth ventricle
- Astrocytomas of cerebellar hemispheres
Define: Astrocytomas
Cancer of the brain and spinal cord originating in glial cells (astrocytes).
Astrocytoma: Characteristics (3)
- Relatively common in children
- 25% of metastatic brain tumors arise in cerebellum
- Paraneoplastic disorders: secondary to cancer in other regions, destroy purkinje cells
Define: Purkinje Cells (3)
- AKA Purkinje Neurons
- Located in the Cortex
Responsible for all output of all motor coordination in the cortex.
Trauma can result in __ __ and __.
limb apraxia, dysarthria
Ataxic Dysarthria: Trauma-related Causes (3)
- TBI
- Injury to the Superior cerebellar peduncles
- Dementia pugilistica
The superior cerebellar peduncles are vulnerable to __ __.
rotational injuries
Dementia pugilistica = __ __.
boxer injury
Ataxic Dysarthria: Toxic/Metabolic-related Causes (3)
- Acute and chronic alcohol abuse
- Anti-convulsants
- Lithium
