Cerebellar Syndrome

Question 1

Patient complains of lack of coordination. What would you examine?

Answer 1

Speech: scanning dysarthria
Eyes: nystagmus (fast phase towards the lesion)
Outstretched arm: rebound phenomenon
Upper limb: hypotonia, hyporeflexia, finger-nose, dysdiadokinesia
Lower limb: wide based gait, heel-shin, foot tapping

Question 2

Causes of cerebellar syndrome (PASTRIES)

Answer 2

Paraneoplastic cerebellar syndrome
Alcoholic cerebellar degeneration
Sclerosis (MS)
Tumour
Rare (Friedrich’s ataxia, ataxia telangiectasia)
Iatrogenic (phenytoin toxicity)
Endocrine (hypothyroidism)
Stroke (brain stem vascular event)

Question 3

Define Spinocerebellar Ataxia

Answer 3

A heterogenous group of autosomal dominant genetic conditions causing degenerative cerebellar syndrome

Question 4

What are the features of Miller-Fisher Syndrome?

Answer 4

Ataxia
Ophthalmoplegia
Loss of lower limb reflexes

Question 5

List 5 types of cancer causing paraneoplastic cerebellar Syndrome

Answer 5

Small cell lung
Breast
Gynae
Testicular
Hodgekin’s lymphoma