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Presentation1

  1. 1. Cerebellum Symptamatology
  2. 2. Primary Manifestations <ul><li>Hypotonia </li></ul><ul><li>Ataxia </li></ul><ul><li>Cerebellar Dysarthria </li></ul><ul><li>Tremor </li></ul><ul><li>Occular dysfunctions </li></ul>
  3. 3. Hypotonia <ul><li>Reduced Muscle tone </li></ul><ul><li>Mostly acute hemispheric lesions </li></ul><ul><li>Mostly in the proximal musculature </li></ul><ul><li>Occurs only with Neocerebellar lesions </li></ul><ul><li>Involves the dentate nucleus </li></ul><ul><li>Pendular reflexes </li></ul>
  4. 4. Tests for hypotonia <ul><li>Ashworth scale for muscle tone </li></ul><ul><li>Passive movement </li></ul><ul><li>EMG </li></ul>
  5. 5. Testing-Adults <ul><li>Passive movement </li></ul><ul><li>Pronator drift for tone </li></ul>
  6. 6. Testing-Children
  7. 7. Ataxia <ul><li>PRIMARY cerebellar sign </li></ul><ul><li>Disturbances of speed, timing , force, range </li></ul><ul><li>Includes dyssynergia, dysmetria, dysdiadokinesia </li></ul><ul><li>Gait distrubances </li></ul><ul><li>Titubation </li></ul>
  8. 8. Testing <ul><li>Dyssynergia – perform complicated movements of the upper extermity –look for smoothness </li></ul><ul><li>Dysmetria- finger to nose </li></ul><ul><li>Dysdiadokinesia – perform rapid alternating movements </li></ul><ul><li>Heel to shin test for dysmetria </li></ul><ul><li>Gait analysis- wide base clumsy movement with high guard </li></ul>
  9. 9. <ul><li>Truncal instability </li></ul><ul><li>Difficulty in tandem walking </li></ul>
  10. 10. Differentation from sensory ataxia <ul><li>Cerebellar </li></ul><ul><li>side to side sway </li></ul><ul><li>High guard </li></ul><ul><li>Romberg’s NEGATIVE </li></ul><ul><li>Giddiness on closing eyes- occasionally </li></ul><ul><li>Sensory </li></ul><ul><li>AP sway </li></ul><ul><li>Loss of feeling of the legs </li></ul><ul><li>Romberg POSITIVE </li></ul><ul><li>No giddiness </li></ul>
  11. 11. Dysarthria <ul><li>Incoordination of the vocal cords </li></ul><ul><li>Stat taco speech – machine gun speech </li></ul><ul><li>Difficulty in articulation and prosody – completion of paragraph </li></ul><ul><li>Volume changes </li></ul><ul><li>Facial grimacing to control muscles </li></ul><ul><li>Slurring , explosive </li></ul>
  12. 12. Tremor <ul><li>Kinetic tremor ( intention tremor) – end of movement tremor </li></ul><ul><li>No termor on gross movement </li></ul><ul><li>Needs the movement to be fine eg. Finger to nose test. </li></ul><ul><li>Differentiate from other forms – almost 13 different forms present. </li></ul>
  13. 13. Non Motor manifestation <ul><li>Spatial dysgraphia </li></ul><ul><li>Emotinal disturbances </li></ul><ul><li>Motor learning problems </li></ul><ul><li>Cognitive affllictions- disinhibitions, sporadic laughter, inapproprate behaviour </li></ul>
  14. 14. Occular dysfunctions <ul><li>Nystagmus- typical – pendular </li></ul><ul><li>Saccadic pursuit </li></ul><ul><li>Opsoclonus </li></ul><ul><li>Skew devation </li></ul><ul><li>Failure to supress the VOR </li></ul>

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