Cerebellar Dysfunction

Question 1

what do cerebellar lesions impact

Answer 1

motor learning, ability to produce selective and coordinated movement, speech, language, working memory

Question 2

what are the possible MOI of cerebellar lesions

Answer 2

stroke or cerebrovascular disease, trauma, tumour
friedreich ataxia, MS, inflammatory diseases
drugs and alcohol

Question 3

what is the clinical presentation of cerebellar lesions
what is ataxia

Answer 3

normal strength and conscious proprioception but abnormal active movement
ataxia: abnormal, uncoordinated movement (change in timing, ROM, force, speed and sequencing of muscle contractions)

Question 4

what is dyssynergia and dysdiadochokinesia

Answer 4

dyssynergia: movement decomposition, unable to perform movements with smooth sequences, looks jerky and robotic
dysdiadochokinesia: difficulty with rapid alternating movements (speed and accuracy affected when alternating between pronation and supination)

Question 5

what are some abnormal active movements you would see in an individual with a cerebellar lesion

Answer 5

difficulty dealing with interaction torques, poor anticipatory motor control, intention tremor

Question 6

what is dysmetria and saccadic dysmetria

Answer 6

dysmetria: undershoots when reaching to a target (hypometria) or overshoots (hypermetria)
saccadic: eye movement under or overshoots a target

Question 7

what is nystagmus and asthenia

Answer 7

nystagmus: involuntary rhythmic movement of eyes, eyes look like they are turning back and forth or moving up and down or side to side
asthenia: sense of generalized weakness or heaviness, everything feels effortful

Question 8

what does the standing arm raise test assess
explain how you would grade this test from 0-3

Answer 8

the ability to control posture in response to interaction torque
0: unable or needs assistance for stability
1: steps to regain equilibrium/unable to move quickly without losing balance
2: visible sway
3: remains stable (normal)

Question 9

T or F: healthy people can experience a normal resting tremor
T or F: cerebellar lesions do not cause resting tremors

Answer 9

T, can be exacerbated by stress, anxiety, hunger or caffeine
T

Question 10

are intention tremors present at rest
what is one disease where you would see an abnormal resting tremour

Answer 10

no
parkinson’s disease

Question 11

what is the prognosis for cerebellar lesions (good/poor)
what should treatment be focused on

Answer 11

poor
compensate for loss because strategies for promoting recovery are limited due to the impairments in motor learning

Question 12

what recovery strategies can you use for cerebellar lesions

Answer 12

aerobic exercise to reduce sense of asthenia
break the movement down and force slow movement to maximize ability to use feedback to correct movement patterns
start with simple tasks that maximize stability and reduce degrees of freedom of movement (pedal exerciser or recumbent bike)

Question 13

what compensatory strategies can you use for cerebellar lesions

Answer 13

planning and pacing activities with frequent breaks (to offset asthenia)
visual cues using a mirror (promote smooth control of movement)
gait aids and other adaptive equipment