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  1. 1. The Cerebellum Bianca Ching CN 02 Kristin Te CN 24
  2. 2. Cerebellum – part of the brain, located under the cerebrum, towards the back, behind the brainstem and above the brainstem. largely involved in "coordination”; persons whose cerebellum doesn't work well are generally clumsy and unsteady
  3. 3. Functions Main Motor Functions : 1) Coordination 2)Speed and smoothness of movements 3)Walking or gait
  4. 4. The cerebellum consists of two halves called cerebellar hemispheres. Each controls one side of the body. Between the hemispheres is a thin central part (vermis) that controls our trunk (posterior vermis) and legs (anterior vermis).
  5. 5. Cerebellar Dysfunction <ul><li>Incoordination (ataxia) </li></ul><ul><li>Inability to walk </li></ul><ul><li>Instability of the trunk (titubation) </li></ul><ul><li>Slurred speech (dysarthria) </li></ul>
  6. 6. Two Distinguishable Cerebellar Syndrome <ul><li>Midline </li></ul><ul><li>Hemispheric </li></ul>
  7. 7. Midline <ul><li>Midline syndromes are characterized by imbalance. Persons are unsteady, unable to stand in Romberg with eyes open or closed, and are unable to well perform tandem gait. </li></ul>Two Distinguishable Cerebellar Syndrome
  8. 8. Midline Disturbances <ul><li>causes &quot;trunkal ataxia&quot; a syndrome where a person is unable to sit on their bed without steadying themselves </li></ul><ul><li>often affect eye movements; there may be nystagmus, ocular dysmetria and poor pursuit. </li></ul>Two Distinguishable Cerebellar Syndrome
  9. 9. Hemispheric <ul><li>characterized by incoordination of the limbs, there may be decomposition of movement, dysmetria, and rebound, dysdiadochokinesis is the irregular performance of rapid alternating movements. </li></ul>Two Distinguishable Cerebellar Syndrome
  10. 10. Hemispheric <ul><li>Intention tremors may be present on an attempt to touch an object. A kinetic tremor may be present in motion. </li></ul><ul><li>The finger-to-nose and heel-to-knee tests are classic tests of hemispheric cerebellar dysfunction. While reflexes may be depressed initially with hemispheric cerebellar syndromes, this cannot be counted on. </li></ul><ul><li>Speech may be dysarthric, scanning, or have irregular emphasis on syllables. </li></ul>Two Distinguishable Cerebellar Syndrome
  11. 11. Sources of Cerebellar Injuries <ul><li>Toxins (ethanol, chemotherapy, anticonvulsants, ethanol). </li></ul><ul><li>Autoantibodies ( paraneoplastic cerebellar degeneration ) </li></ul><ul><li>Structural lesions (strokes, MS, tumors, etc)Inherited cerebellar degenerations </li></ul>
  12. 12. <ul><li>The diagnosis of a cerebellar disorder is usually made by a neurologist, and is usually straightforward. MRI scanning often shows shrinkage of part or all of the cerebellum although this is not always the case. Blood tests for specific conditions are now commonly used when there is a family tendency towards these types of symptoms. </li></ul>
  13. 13. Ataxia <ul><li>Ataxia comes from the Greek  a taxia , meaning literally &quot;no order&quot;. It is a blanket term referring to a loss of ability to control one's muscles. Ataxia has a number of causes and a number of treatments. </li></ul>What is Ataxia?
  14. 14. <ul><li>Ataxia can be broken into two distinct groups: sporadic and hereditary. Hereditary ataxia can usually be traced to a family history, and can be linked to twenty-two gene mutations. These mutations are labeled “ spinocerebellar ataxia type 1&quot; through 22 in shorthand referred to simply as SCA1-22. Sporadic ataxia is a form of ataxia which is not linked to a genetic defect. </li></ul>Ataxia
  15. 15. Kinds of Ataxia <ul><li>Hereditary ataxia can be separated into types caused by a metabolic defect. </li></ul><ul><li>They are inherited from a defective gene, and the identification of these genes continues at an encouraging pace. </li></ul>Hereditary Ataxia
  16. 16. Hereditary Ataxia <ul><li>Some of the many types of hereditary ataxia include: </li></ul><ul><li>Machado-Joseph disease </li></ul><ul><li>ataxia with opthalmoplegia, spinopontineatrophy </li></ul><ul><li>ataxia with etinopathy </li></ul><ul><li>slow-eye movement ataxia </li></ul>Kinds of Ataxia
  17. 17. Sporadic Ataxia <ul><li>Sporadic ataxia is very difficult to diagnose, and often doctors will struggle as they rule out every possibility of hereditary ataxia before making a final diagnosis. </li></ul><ul><li>Some of the many terms used to describe sporadic ataxia are: spastic ataxia, Menzel's ataxia, Marie's ataxia, Holmes'ataxia, sporadic atrophy, and most commonly sporadic OPCA, or sporadic olivopontocerebellar atrophy. </li></ul>Kinds of Ataxia
  18. 18. <ul><li>a disturbance of body equilibrium in standing  or walking, resulting in an uncertain gait and trembling, especially  resulting from diseases of the cerebellum. </li></ul>What is Titubation? Titubation
  19. 19. Causes of Titubation <ul><li>The following medical conditions are some of the possible causes of Titubation. There are likely to be other possible causes, so ask your doctor about your symptoms.  </li></ul><ul><li>1. Space-occupying lesions </li></ul><ul><li>2. Cerebellar Lesions </li></ul><ul><li>3. Multiple Sclerosis (MS) </li></ul><ul><li>4. Pelizaeus-Merzbacher Disease </li></ul>Titubation
  20. 20. Causes of Titubation <ul><li>5. West Syndrome (Infantile Spasms) </li></ul><ul><li> 6. Rett Syndrome </li></ul><ul><li> 7. Guillain-Barre Syndrome </li></ul><ul><li> 8. Friedreich's Ataxia (FRDA) </li></ul><ul><li> 9. Cerebrospinal Fluid </li></ul><ul><li> 10. Meningitis </li></ul><ul><li> 11. Complications of HIV Infection </li></ul>Titubation
  21. 21. What is Dysarthria? <ul><li>Dysarthria is a motor speech disorder. The muscles of the mouth, face, and respiratory system may become weak, move slowly, or not move at all after a stroke or other brain injury. The type and severity of dysarthria depend on which area of the nervous system is affected. </li></ul>Dysarthria
  22. 22. Causes of Dysarthria <ul><li>Some causes of dysarthria include stroke, head injury, cerebral palsy, and muscular dystrophy. Both children and adults can have dysarthria. </li></ul>Dysarthria
  23. 23. Symptoms of Dysarthria <ul><li>&quot;Slurred&quot; speech </li></ul><ul><li>Speaking softly or barely able to whisper </li></ul><ul><li>Slow rate of speech </li></ul><ul><li>Rapid rate of speech with a &quot;mumbling&quot; quality </li></ul><ul><li>Limited tongue, lip, and jaw movement </li></ul><ul><li>Drooling or poor control of saliva </li></ul>Dysarthria
  24. 24. <ul><li>Abnormal intonation (rhythm) when speaking </li></ul><ul><li>Changes in vocal quality (&quot;nasal&quot; speech or sounding &quot;stuffy&quot;) </li></ul><ul><li>Hoarseness </li></ul><ul><li>Breathiness </li></ul><ul><li>Chewing and swallowing difficulty </li></ul>Symptoms of Dysarthria Dysarthria
  25. 25. That’s Up! :) P.S. If you are currently experiencing those symptoms, please see your physician!:) Health is Wealth!