Station 3.14: Cerebellar syndrome

Question 1

clinical signs

What are the clinical signs of Cerebellar syndrome?

Cerebellar syndrome

This 37‐year‐old woman has noticed increasing problems with her coordination. Please examine her and suggest a diagnosis.

Answer 1

https://1drv.ms/i/s!AofDuV8g6bhQge8uKZSRPWwhdHCUqA?e=t9BcuL

Question 2

Discussion - Mnemonic for signs D.A.N.I.S.H.

What is the Mnemonic for the clinical signs of Cerebellar syndrome?

Cerebellar syndrome

This 37‐year‐old woman has noticed increasing problems with her coordination. Please examine her and suggest a diagnosis.

Answer 2

D.A.N.I.S.H.

Dysdiadochokinesis
Ataxia
Nystagmus
Intention tremor
Scanning dysarthria
Hypotonia/hyporeflexia

https://1drv.ms/i/s!AofDuV8g6bhQge8v1mh2qsNxPboPrQ?e=52q95F

Cerebellar lesion
The fast-phase direction is TOWARDS the side of the lesion, and is maximal on looking TOWARDS the lesion.
Vestibular nucleus/VIII nerve lesion
The fast-phase direction is AWAY FROM the side of the lesion, and is maximal on looking AWAY FROM the lesion.

In this case the nystagmus could be due to a cerebellar lesion on the LEFT
or a vestibular nucleus lesion on the RIGHT.

Question 3

Discussion - causes

What are the causes of Cerebellar syndrome?

Cerebellar syndrome

This 37‐year‐old woman has noticed increasing problems with her coordination. Please examine her and suggest a diagnosis.

Answer 3

P.A.S.T.R.I.E.S.

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

Question 4

Discussion - Aetiological clues

What are the Aetiological clues of Cerebellar syndrome?

Cerebellar syndrome

This 37‐year‐old woman has noticed increasing problems with her coordination. Please examine her and suggest a diagnosis.

Answer 4

https://1drv.ms/i/s!AofDuV8g6bhQge8wVm-fMprotsSmlQ?e=l8HhaS