Cerebellar Exam Flashcards
What abnormalities of gait may be seen in cerebellar disease?
Broad based gait
Staggered gait, often slow and unsteady
Which area of the cerebellum does the heel-to-toe walk particularly good at testing for?
Cerebellar vermis
In the Romberg’s test, what does falling without correction indicate?
Sensory ataxia due to lack of proprioception (NOT cerebellar disease)
What abnormalities of speech can occur in cerebellar dysfunction?
Slurred, staccato speech
What is physiological nystagmus
A few beats of nystagmus at the extremes of gaze
Presence of nystagmus is often enough to indicate a pathology, but how else can it be further characterised?
Direction - fast phase is towards lesion
Horizontal or vertical gaze
Beats around a horizontal or vertical plane
What would you see if saccades were present?
The patient would overshoot the target they are looking for and then correct to the target
How may the persuit of eye movements be affected in cerebellar pathology?
Imapaired - jerky eye movements
What is the difference between an intention tremor and an action tremor?
Intention tremor - occurs at the end of the movement
Action tremor - persists throughout the whole action
What is the effect on tone from cerebellar lesions?
Tone tends to be reduced on the side of the lesion
What does an inability to perform dysdiadochokinesia suggest?
Cerebral ataxia
What is a positive rebound phenomenon test?
Arm shoots up beyond original placement
What is the effect on lower limb reflexes from cerebellar pathology?
Pendular in motion
What does the mnemonic DANISH stand for in terms of remembering the key points of cerebellar exam?
Dysdiadochokinesia Ataxia (gait and posture) Nystagmus Intention tremor Slurred, staccato speech Hypotonia/Heel-shin test
