Cerebellar Syndrome

Question 1

Defintion

Answer 1

Cluster of clinical manifestations resulting from impaired function of the cerebellum = responsible for maintaining balance and co-ordination of movements

Question 2

Aetiology (VITAMIN C)

Answer 2

Vascular - Stroke (Ischaemic or Haemorrhagic)
Infections - Lyme disease, cerebellar abscess
Inflammatory - MS
Traumatic - to posterior fossa
Metabolic - Alcoholism
Iatrogenic - phenytoin, carbamazepine
Neoplastic
Congenital/hereditory - Friedreich’s ataxia

Question 3

Physiology

Answer 3

The cerebellum can also be divided by function:
- Cerebrocerebellum: planning movement and motor learning
- Spinocerebellum: regulating body movement by allowing for error correction
- Vestibulocerebellum: controlling balance and ocular reflexes, mainly fixation on a target.

Question 4

Symptoms (DANISH)

Answer 4

Dysdiadochokinesia
Ataxia
Nystagmus
Intention tremor
Slurred speech
Hypotonia

Cerebellar hemisphere lesion will provoke signs in the ipsilateral limb

Question 5

Diagnosis

Answer 5

CT/MRI: structural abnormalities
Serological tests: infectious or inflammatory causes
Lumbar Puncture: infection, inflammation or malignancy
Genetic testing: hereditory conditons

Question 6

Management

Answer 6

Medications: treat underlying infections
Surgery: remove tumours or address trauma
Rehabilitation therapies
Lifestyle mod: Alcohol cessation for alcohol related cerebellar atrophy and dysfunction