Cerebellum Clinical Correlates

Question 1

Cardinal features of cerebellar dysfunction

Answer 1

Hypotonia, ataxia, dysarthria, tremor, ocular motor dysfunction.

Question 2

Vermis syndrome

Answer 2

Wide based gait, titubations (nodding of head). Gait ataxia, but relatively little peripheral ataxia. Some nystagmus present. Can be caused by alcohol or 4th ventricle obstruction

Question 3

Hemispheric Cerebellar Syndrome

Answer 3

Incoordination of ipsilateral limb movements, impaired rapid alternating movements, trouble with finger movements, scanning speech. Cause by infarcts, neoplasms. Also has intention tremor.

Question 4

Pancerebellar Syndrome

Answer 4

Has all of the above: wide gait, gait ataxia, incoordination of ipsilateral limb movements. Can be caused by infection, neoplasms

Question 5

Can eye signs (nystagmus, etc) be localized to a particular part of the cerebellum?

Answer 5

No.

Question 6

Difference between ataxic gait with midline cerebellar lesion or hemispheric cerebellar lesion

Answer 6

With midline: ataxic staggering movements are in all directions.

With hemisphere: staggering/falling to the side of the lesion

Question 7

Hypotonia secondary to cerebellar disease

Answer 7

Usually due to acute problem, ipsilateral to affected side. Not usually seen with chronic problems. More noticeable in upper limbs.

Question 8

Check and rebound in cerebellum issues

Answer 8

If arms pushed down, normally rebound and stop. In cerebellar disfunction, arms go all the way up.

Question 9

Cerebellar dysarthria

Answer 9

Generally scanning or garbled. Most seen with hemispheric lesions. May be due to hypotonia.

Question 10

Resting tremor

Answer 10

Maximal tremor at rest, gets better with movement. Parkinsons.

Question 11

Postural tremor

Answer 11

Maximal with a limb positioned against gravity. Gradual onset is indicative of essential or physiologic tremor. Acute onset is indicative of a toxic/metabolic disorder.

Question 12

Intention tremor

Answer 12

Maximal when reaching towards a target. Gets worse closer to target. Sign of cerebellar dysfunction. Can be due to MS or wilson’s disease too.

Question 13

What suppresses essential tremor?

Answer 13

Alcohol/sedatives

Question 14

Myoclonus

Answer 14

Quick movement of muscle. Cannot be suppressed (like a tic)

Question 15

Cerebellar syndromes in children caused by

Answer 15

Infection: H. influenzae, Varicella

Question 16

CJD

Answer 16

Progressive ataxia and dementia. Caused by prions. Granule cell loss.

Question 17

Telangiectasia

Answer 17

Capillary dilations that can signify ataxia sometimes.