The Cerebellar Patient

Question 1

Functions of the cerebellum

Answer 1

Coordinates voluntary motor dexterity via posture and balance. Also plays role in cognition/mental dexterity

Afferent Cerebellar Tracts:
1. Spinocerebellum: general proprioception
2. Vestibulocerebellar: inner ear receptors
3. Cerebrocerebellum: UMN system, cerebral cortex

Question 2

Clinical signs of cerebellar disease (5)

Answer 2

1. Cerebellar ataxia (TL hypermetria, a staggering/non-paretic gait, balance problems)
2. Titubation (truncal swaying motions)
3. Intention tremor (head and neck)
4. Increased muscle tone
5. Vestibular signs

Question 3

Decerebellate Rigidity

Answer 3

posture seen with cerebellar lesion (extended neck + TLs, flexed hips/PLs)
- normal mentation

looks same as decerebrate rigidity; difference = mentation!

Question 4

Paradoxical Vestibular Disease

Answer 4

• Caused by a central vestibular lesion (in the cerebellum)
• Paradox = head tilt contralateral to lesion/proprioceptive deficits, and fast phase of nystagmus ipsilateral to lesion (normal vestibular disease = opposite)

Question 5

Cerebellar Cortical Abiotrophy
1. Pathophysiology
2. Signalement
3. Prognosis

Answer 5

1. Cerebellum normal at birth. Inherited/genetic progressive, degenerative disease of normal neurons.
2. 4-6 y/o American Staffordshire Terriers
3. No tx; is a progressive disease so ataxia will worsen with age