Neurology- Lecture 19: Cerebellum

Question 1

What are the functions of the cerebellum?

2

Answer 1

• cor-ordination
• control of posture and gait
• regulation of muscle tone(can control the length of the reticulospinal tract which controls length of muscle spindles)
• Emotional Regulation (Emotion stored with programs)
• Autonomic regulation-section of cerebellum responsible for cardio-regulation
• cerebellum functions ipsillaterally (if your testing R side of cerebellum your testing R side)

Question 2

Review anatomy on slide 3 and 4

Answer 2

h

Question 3

What is the functional organisation of the cerebellum?

Answer 3

1. Vestibulocerebellum:
   Flocculonodular lobe- balance so called vestibularcerebellum
2. Spinocerebellum
   -anterior lobe
   -vermis
   -paravermis
   (a lot of processes haooen here including comparing intended movement to actual movement)
3. Cerebrocerebellum (lateral hemispheres)

Question 4

Cerebellar nuclei

6

Answer 4

-Fastigial
-globose
-eboliform
(last 2 = Interposed nuclei)
-dentate

feel good every day

Question 5

Check out the slide on ‘Quality control’ pg 8.
Describe it.
Or a better one is pg 372 of DR necks textbook

Answer 5

There are connections between the fastigial nucleus and the VL thalamus and motor cortex that contribute to the anterior or ventral CORTIcospinal tract. These pathways help to control head, neck and proximal limb movements. Therefore- face, mouth, neck and balance or postural control during voluntary motor tasks.

Question 6

Look at the slide on pg 9 of how the cerebellum and vestibular system help to control balance.

Answer 6

know it, draw it

Question 7

What is the importance of the Inferior Olivary Nucleus?

Answer 7

• provides climbing fibres to the cerebellar cortex
• recieves projections from the C/L interposed and dentate nucleus (received proposed plan and what actually happening)
• recieves projections from the spinal cord, red nucleus, cerebral cortex and cerebellum.
• 3 Copies of motor information-intended, actual and revised
• may identify motor ‘errors’ between the copies (the learning and comparator hypotheses)

Question 8

Cerebellar Lesions:
Important.
What symptoms would you see with someone who has a
1. Anterior Lobe Syndrome 
2. Cerebrocerebellar syndrome 
3. Flocculonodular lesions

Answer 8

1. Anterior lobe syndrome–> Broad based staggering gait, ataxia, dysarthria
2. Cerebrocerebellar Syndrome- Hypotonia, Hyporeflexia,
   - dysmetria(can’t form plan)
   - intention tremor
   - dysdiadochokinesia- rapid movements
3. Flocculonodular lesions:
   - Dysequilibrium (dizziness, Vertigo), truncal ataxia (incoordination of trunk-constantly fall), nystagmus

Slide 12- with explanations on slide 12 below

Question 9

Learn the table on slide 12- signs of cerebellar disorders

Answer 9

h

Question 10

Selected conditions of the cerebellum
1. Chari Malformations.
what is it what happens, what may they get?
13

Answer 10

Type 1

• herniation of cerebellar tonsil through foramen magnum
• myelopathy, medullary and cerebellar compression may occur.
• HA and neck pain common
• Hydrocephalus uncommon
• may have syringomyelia

Type 2
-Assosiated with meningomyelocele- which may block the foramen or decrease drainage or blockage of the central canal

Question 11

Condition:
Cerebellar stroke
14

Answer 11

-uncommon
-ischaemic or haemorrhagic
-SCA, AICA, PICA arteries
-vertigo
-nausea
-vomiting
-truncal ataxia -concern-cant stand
-35% misdiagnosis rate
be very concerned with non fatiguing nystagmus

Question 12

How would you carry out a cerebellar exam?

Answer 12

• Scanning speech
• Nystagmus-fast phase towards lesions
• finger to nose test
• rapid alternating movements
• hell to shin test
• rebound phenomenon
• gait