Cerebellar Disorders

Question 1

Cerebellar Disorders Movement System Diagnoses

Answer 1

Movement Pattern Coordination Deficit
Dysmetria

Question 2

Cerebellar Disorders Prognosis

Answer 2

Better
- Metabolic causes
- Static, small focal lesions - MS
- Trunk ataxia
- Ischemic stroke
- PICA or AICA
- No CB nuclei involvement
Worse
- Degenerative diseases
- Multiple, large focal lesions - MS
- Limb ataxia
- Hemorrhagic stroke
- SCA
- CB nuclei involvement

Question 3

Vertebral & PICA Stroke Signs & Symptoms

Answer 3

Vertigo
Nausea
Hoarsness
Dysphagia
Ipsilateral ataxia
Ptosis
Impaired sensation of the ipsilateral face and contralateral torso & limbs

Question 4

Autosomal dominant cerebellar disorders

Answer 4

Spinocerebellar ataxias
Midlife onset
Slowly progressive

Question 5

Autosomal recessive cerebellar disorders

Answer 5

Friedreich ataxia
Onset 5-15yo - 15% get symptoms after 25
10-20y before confined to a wheelchair
Individuals completely incapacitated in later stages
Life expectancy shortened from heart complications

Question 6

Ataxia S&S

Answer 6

Lack of coordination
Slurred speech
Trouble eating
Trouble swallowing
Eye movement
Fine motor skill deterioration
Difficulty ambulating
Gait deviation
Tremors
Heart problems

Question 7

Dysfunction of voluntary movement signs & symptoms

Answer 7

Dyssynergia & dysmetria of ocular motion & limb movements
Dysdiadochokinesia
Lack of check
Movement decomposition
Postural control & balance deficits
Gait ataxia

Question 8

Hypotonia

Answer 8

Low muscle tone

Question 9

Cerebellar tremors

Answer 9

Action tremor that is slow velocity high amplitude
Postural tremor
Kinetic tremor - intention

Question 10

Nystagmus

Answer 10

Uncontrolled repetitive eye movements
Can be spontaneous or gaze-evoked

Question 11

Cerebellar disorders diagnosis-specific tests & measures

Answer 11

Scale for Assessment and Rating of Ataxia (SARA)
International Cooperative Ataxia Rating Scale (ICARS)
Brief Ataxia Rating Scale (BARS)
Friedrich Ataxia Rating Scales (FARS)
Composite Cerebellar Functional Severity (CCFS)
Action Research Arm Test (ARAT)

Question 12

Cerebellar Disorders Health condition & BSF Impairments

Answer 12

Spinocerebellar ataxias
Freidreich’s Ataxia
Poor timing, sequencing, and consistency of movement
Difficulty with intersegmental movement
Difficulty with anticipatory and reactive postural responses
Difficulty with motor learning
Difficulty grading forces & scaling movements

Question 13

Cerebellar Disorders Interventions

Answer 13

Coordination training
Proximal stability/ trunk strengthening
Fall prevention & fall strategies
Endurance exercise with medical clearance
Explicit motor control strategies

Question 14

Cerebellar Disorders Special considerations

Answer 14

Cardiac complications are common
Speech deficits are common
SCAs have an increase in CAG triplets producing a protein that leads to neuronal death and CB degeneration
Friedreich’s ataxia is the most common autosomal recessive hereditary ataxia

Question 15

Dysarthria

Answer 15

Scanning speech/Ataxic dysarthria
- spoken words are broken up into separate syllables, often separated by noticeable pauses and spoken with varying force

Question 16

Dyssynergia

Answer 16

impairment of multi-joint movement related to dysmetria and deficits in limb dynamics predictions

Question 17

Dysdiadochokinesia

Answer 17

deficits in coordinating agonist-antagonist muscle pairs, elicited during rapid alternating movements/rapid reversals

Question 18

Dysmetria

Answer 18

the impaired ability to scale movement distance; slow movements tend to produce hypometria and fast movements tend to produce hypermetria

Question 19

Movement decomposition

Answer 19

breaking down of a movement sequence or multi-joint movement into a series of separate movements to simplify the movement
(this may actually represent a compensatory strategy)

Question 20

Lack of Check

Answer 20

inability to halt unintended movement (excessive rebound)