Neuroanatomy

Question 1

What are the clinical findings of cerebellar disease?

Answer 1

DANISH PASTRIES

D - dysdiadochokinesis
A - ataxia
N - nystagmus (recall cerebellar nystagmus is away from lesion)
I - intention tremor
S - staccato speech/scanning dysarthria
H - hypotonia/hyporeflexia and heel-shin test

P - past pointing

PASTRIES is also useful mnemonic for causes of cerebellar dysfunction

Question 2

What are the causes of cerebellar dysfunction?

Answer 2

Paraneoplastic cerebellar syndrome
Alcoholic degeneration
Sclerosis (MS)
Tumour (posterior fossa SOL)
Rare (Friedrich's and ataxia telangiectasia)
Iatrogenic (phenytoin)
Endocrine (hypothyroidism)
Stroke (brain stem vasc event)

Question 3

causes of CN III palsy?

Answer 3

there is old teaching that says surgical causes compress the superficial parasympathetic papillary fibres

causes:
M for medical
Mononeuritis multiplex (e.g. DM)
Midbrain infarction (Weber's)
Midbrain demyelination (MS)
Migraine

C for cutting (Surgical)

Communicating artery aneurysm (post)
Cavernous sinus path (would expect IV, V and VI to be impacted)
Cerebral uncus herniation