Cerebellum

What is the most remarkable and debilitating effect of cerebellar damage?

Ataxia

What are the functions of the 3 parts of the cerebellum:

• Visibulocerebellum

• Spinocerebellum

• Cerebrocerebellum

• Visibulocerebellum:

  • Balance control

  • Posture

  • Control of gaze

• Spinocerebellum

  • Posture

  • Coordination?

• Cerebrocerebellum

  • Coordination

  • Motor learning

  • Initiation of movements

What is a degenerative disease that affects the cerebellum?

MS

What are the symptoms of a superior cerebellar artery stroke?

• Dysmetria of ipsilateral arm movements

• Dysarthric speech

• Nystagmus

• Unsteadiness in walking

What are the symptoms of an anterior inferior cerebellar artery stroke?

• Cerebellar and extracerebellar signs including:

• Vestibular signs

• Facial sensory loss (due to damage to pons)

• Dysmetria

What are the symptoms of a posterior inferior cerebellar artery stroke?

• Vertigo

• Walking ataxia

• Nystagms

• Unsteadiness

What makes a patients dysmetria worse?

Movements that involve multiple joints

What is dyssenergia?

Movement of specific segments are not properly sequenced (range or direction).

Lack of organization. Have a strange trajectory to a target. Unable to control joint ROM/contraction.

Dysmetria: how close you were to target

Dysserngia: how you got to the target

What is lack of check?

Inability to halt a movement of a body part after a strong isometric force (sudden release)

How does a cerebellar tremor differ from a tremor of a pt with PD?

Cerebellar tremor only occurs during action of the muscle. Rest = no tremor. Movement = tremor.

Called an action tremor

What is an intention tremor?

Tremor that occurs druing the terminal portion of visually guided movements during a target.

How you know: ask ot to close their eyes and go to pick something up. If they have no tremor at all, they have intention tremor due to lack of visual feedback.

What is a titubation

Rhytmic tremor of head, trunk, or both

What are the oculomotor deficits present with cerebellar dysfunction?

• Saccades: slow and dysmetric

  • Moving eyes between targets

• Pursuit: choppy

• Ability to cancel the VOR may be impaired or absent

What speech impairments are present due to cerebellar dysfunction?

Ataxic dysarthria. Muscular coordination problem

Cerebellum-dependent motor learning is driven by what?

Errors directly occurring during the movement

What supplement can improve patients with ataxia?

Vitamin E

What are two standardized clinical scales used to assess ataxia as the main problem in patients with CB damage?

The International Cooperative Ataxia Rating Scale (ICARS)

The Scale for the Assessment of Rating Ataxia (SARA)