Principles of Ataxia Flashcards
What is hypometria?
Shortened protraction phase of gait
What is ataxia?
Neurological signs consisting of gross incoordination of muscle movements
What is hypermetria?
Longer protraction phase of gait
What is dysmetria?
Impairment of the ability to control the distance, power and speed of an action
Where is sensory ataxia localised to?
General proprioceptive pathways which are the peripheral nerve, dorsal root, spinal cord, brainstem and forebrain
What are the clinical signs associated with sensory ataxia?
Abnormal postural reactions and limb paresis
Where is vestibular ataxia localised to?
Vestibular apparatus including the vestibular nuclei, vestibular portion of CN VIII and vestibular receptors
What are the clinical signs associated with vestibular ataxia?
Head tilt, leaning/falling/rolling to one side, abnormal nystagmus, positional strabismus and normal/abnormal postural reactions
Where is cerebellar ataxia localised to?
Cerebellum
What are the clinical signs associated with cerebellar ataxia?
Wide-based stance, intention tremors, loss of balance, truncal sway, delayed onset and hypermetric hopping, ipsilateral menace deficits with normal vision, no limb paresis or conscious proprioception deficits and pendular nystagmus
What makes up the vestibular system?
Semi-circular canals in the ear contain vestibular hair cells with vestibular receptors that either depolarise or hyperpolarise depending in which way the hairs move resulting in feedback on velocity and gravity to the vestibular nuclei centrally
How do you test the vestibular system?
Oculovestibular reflex = slow flicking of the eyes when turning the head so vision doesn’t blur
What is the pathway of the oculovestibular reflex?
Hair cells -> vestibular receptors -> vestibular nuclei -> oculomotor nerve/abducens nerve -> left medial rectus/right lateral rectus
Why do extensor muscles lose tone in vestibular disease?
Vestibular system accounts for extensor muscles on the same side so if there is a lesion there is a loss of tine of extensor muscles on that side of the body so that side drops
What are the inputs into the vestibular system?
Head motion and angular acceleration from the semicircular canals
Head position and gravity from the saccule and utricle
Visual, proprioceptive and tactile inputs
What are the outputs of the vestibular system?
Forebrain for perceived orientation
Spinal cord and cerebellum
Oculomotor system and eye movements