Cerebellar Disease Flashcards
What’s the overview of key symptoms
-Truncal and Gait ataxia
-Limb Ataxia
-Dysarthria
-Abnormal Eye movements
+/- vertigo
+/- Nausea/vomiting
What could you see with Truncal and Gait Ataxia
- May be unsteady without support
- stands/walks with a broad base (feet wide apart)
- Steps are irregular in timing/distance, side-to-side
*Seen best when walking ‘heel-to-toe’ (tandem gait)
**may be the only sign of cerebellar disease!!
What could you see with Limb Ataxia?
- Clumsiness, difficulty writing
- Abnormal drift of outstretched arms
- Sudden rebound after limb displacement
- Dysmetria @ nose-finger and heel-knee-shin tests
- Impaired hand flip
**Reflects disease of cerebellar hemispheres and then ataxia will be on the same side!
Dysmetria?
Intention tremor that occurs when you move closer to the object.
Will cause you to overstep the mark
How would dysarthria present?
Loss of articulation → slurred, staccato speech
Especially with “st”
May not know how if sounds to others
Staccato as it may be easier for the patient
how do Abnormal Eye movements present?
Nystagmus: rhythmic, oscillatory movements of one or both eyes
*often ass. with oscillopsia (oscillations of the environ)
When would Nausea and vomiting present as a symptom?
Only with acute disease!
Chronic problems allow the brain to adjust, so it’s not an issue
“In cerebellar disease, tone will be ______”
increased or decreased
“In Cerebellar disease, power, tendon reflexes, plantar responses and sensation is ______”
normal
What are the 7 overall causes of cerebellar disease?
- Congenital abnormalities
- Inherited degenerative diseases of cerebellum
- Inflammation/demyelination
- Tumours
- Vascular Disease
- Infections
- Metabolic Disorders
What is a type of inherited degenerative cerebellar disease?
Spinocerebellar disease ‘Ataxia’
Type 1 and 2
Both due to CAG repeats (like huntingtons)
What types of inflammation/demyelination can occur to cause cerebellar disease
Multiple Sclerosis: causes lesions in different areas, cerebellu especially effected due to high amount of myelinated fibres
Other Autoimmune diseases:
What types of vascular disease can lead to cerebellar disease?
- Ischaemic Stroke (infarct): often brainstem involved
- Haemorrhage
What types of infections can causse cerebellar disease?
- Bacteria→ cerebellar abscess
- Virus
- Prion disease
What types of metabolic disorders can cause cerebellar disease?
- Hypoxia, ischaemia, hyperthermia
- Toxins: alcohol, drugs, heavy metal
- Vitamin deficiency: thiamine
- Hereditary metabolic issues
- Hypothyroidism
