Lesion localisation with whole body signs

Question 1

Clinical signs with a lesion in the vestibular lesion - peripheral lesion (CNVIII)

Answer 1

• head tilt (towards lesion)
• falling/leaning/circling (towards lesion)
• nystagmus (slow phase to lesion)

Question 2

Clinical signs with a lesion in the vestibular system - central lesion (CNVIII or brainstem)

Answer 2

• head tilt (towards lesion)
• falling/leaning/circling (towards lesion)
• nystagmus (slow phase to lesion)
• proprioceptive deficits (on side of lesion)
• depression (esp if brainstem involvement)

Question 3

Clinical signs with a lesion in the cerebellum

Answer 3

• ataxia without weakness, hyper-metric gait, truncal sway
• absent menace response (care with neonates)
• wide base stance, intention tremors

Question 4

Clinical signs with a lesion in the cerebrum

Answer 4

• opisthotonos (rigid hyperextension of the neck i.e. head right back)
• blindness (with intact PLR)
• abnormal mentation, behaviours and vocalisation
• aimless wandering, propulsive circling
• seizures