Cerebellar Disorders.pptx
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This document discusses signs and symptoms of cerebellar disorders, including asthenia, ataxia, adiadochokinesia, asynergia, abnormal posture, atonia, nystagmus, scanning speech, intentional tremors, past pointing, pendular knee jerk, and drunken gait. It also provides examples of tests to check for cerebellar dysfunction, such as finger-nose coordination tests. Potential causes of cerebellar disorders include congenital malformations, hereditary ataxias, acquired conditions, senile degeneration, ischemia, infection, and toxins. Management focuses on postural stability, balance training, strengthening, and stretching exercises.
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Anterior lobe
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Ataxia is a lack of muscle coordination that can be caused by cerebellar, sensory or vestibular dysfunction. Signs of cerebellar disorders include ataxia, decomposition of movement, dysarthria, dysdiadochokinesia, dysmetria, hypotonia, nystagmus, scanning speech, and intention tremor. Causes include hereditary conditions like spinocerebellar ataxia or Friedreich's ataxia, congenital malformations, degenerative conditions, tumors, systemic issues, drugs, and toxins. Management involves clinical diagnosis plus MRI imaging and supportive care as well as treating any underlying causes if present.
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2) Performing a physical exam including vital signs, general exam, and focused neurological exam of cranial nerves, motor and sensory systems.
3) Evaluating mental status, cognition, and primitive reflexes.
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Covers types of strokes and common stroke syndromes. Most of the pictures are from the anatomy book of BD Chaurasia for easy understanding.
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2) Extradural lesions typically present with radicular pain and asymmetrical sensory changes. Intradural lesions can cause suspended sensory loss and dissociative sensory changes.
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Inheritance
Friedreich Ataxia Treatment & Management
Diagnosed
Treatment
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medicine.Diseases of the spinal cord.(dr.hawar)
1) Diseases of the spinal cord can be categorized as intramedullary (intrinsic) or extramedullary (extrinsic). Common causes of acute transverse myelopathy include trauma, tumors, infections, vascular disorders, and demyelination.
2) Cervical spondylosis is a degenerative condition that can compress the cervical cord, resulting in neck pain and stiffness as well as arm and leg symptoms.
3) Multiple sclerosis is a frequent cause of symmetric or asymmetric paraparesis in young adults, presenting with hyperreflexia and sensory ataxia.
Repetitive Nerve Stimulation (RNS)
This document provides information about repetitive nerve stimulation (RNS) testing, including:
1) RNS is used to evaluate neuromuscular junction disorders like myasthenia gravis by assessing changes in the compound muscle action potential with repetitive nerve stimulation.
2) In myasthenia gravis, the safety factor is reduced due to fewer acetylcholine receptors, so some endplate potentials may not reach threshold, causing a decremental response on RNS.
3) The protocol for RNS involves stimulating multiple nerves at rest and after exercise to look for an abnormal decremental or incremental response that indicates impaired neuromuscular transmission.
localization spinal cord
1. A 32-year-old woman presented with progressive weakness of all four limbs over two months. Examination showed moderate weakness equally in all limbs without wasting, normal tone and reflexes, and no sensory issues, consistent with ALS.
2. An 18-year-old presented with sudden onset weakness of all four limbs for three days. Examination found weakness, diminished tone and reflexes, and vibration sense loss in the toes, consistent with transverse myelitis.
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This document provides information about Baymax, who introduces himself as a personal healthcare provider. It then provides details on performing a physical exam, including preparing for the exam, establishing rapport with the patient, ensuring privacy and comfort, and explaining findings. Common symptoms that may warrant examination are listed. The physical exam components covered include vital signs, skin, head, eyes, ears, nose, mouth, neck, lungs, heart, abdomen, back, extremities, neurologic exam and mental status exam.
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Here are the key points to remember during history taking for ataxia due to drugs and toxins:
- Detailed drug history including prescription medications, over-the-counter drugs, supplements, herbal remedies, alcohol use
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Taking a thorough
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2. Nurses play an important role in conducting and documenting the neurological exam. This includes setting up equipment, assessing vital signs, performing tests of mental status, cranial nerves, motor skills, sensation, and reflexes, and communicating findings to doctors.
3. The goal of the neurological exam is to determine if there is any disease or abnormality present in the nervous system by thoroughly assessing multiple domains of neurological function.
localization and control of gait and posture disorders
This document discusses localization and control of posture and gait disorders. It provides details on:
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3. Examination of posture and gait, including arising from sitting, stance, walking, and specific postural responses.
4. Classification of gait patterns into lower, middle, and higher level disorders based on neurological functions.
Motor System Examination
This document provides an outline for examining the motor system, including muscles, reflexes, tone, and coordination. It describes the anatomy and examination of major muscle groups in the upper and lower limbs, including specific tests to assess muscle power on a standardized grading scale. Examination of posture, movement, tone, and reflexes is also outlined. The goal is to provide a thorough yet concise motor examination.
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the gait.pptx
This document discusses various types of gait abnormalities and their causes. It begins by covering normal gait and the gait cycle. It then describes different types of abnormal gaits such as antalgic, propulsive, hemiplegic, myopathic, steppage, sensory ataxia, festinating, scissor, frontal lobe, ataxic, choreic, dystonic, and cautious gaits. It discusses anatomical structures involved in gait and balance as well as disorders that can cause gait abnormalities. The document provides details on evaluating patients with gait disorders.
the gait.pptx
This document discusses various types of gait abnormalities and their causes. It begins by covering normal gait and the gait cycle. It then describes different types of abnormal gaits such as antalgic, propulsive, hemiplegic, myopathic, steppage, sensory ataxia, festinating, scissor, frontal lobe, ataxic, choreic, dystonic, and cautious gaits. It discusses anatomical structures involved in gait and balance as well as disorders that can cause gait abnormalities like pain, joint issues, weakness, and neurological impairments. The document provides details on evaluating patients with gait disorders.
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- 1. Cerebellar Disorders • Cerebellar disorders have numerous causes, including congenital malformations, hereditary ataxias, and acquired conditions.
- 2. Cerebellar Disorders ASTHENIA (Weakness) • Muscle shows decreased resistance to passive movements.
- 3. Cerebellar Disorders ATAXIA (Un- steadyness ) • It means that person with cerebellar disorder can not walk straight or can not turn quickly. • People with cerebellar ataxia may initially present with poor balance, which could be demonstrated as an inability to stand on one leg or perform tandem gait. As the condition progresses, walking is characterized by a widened base and high stepping, as well as staggering and lurching from side to side.
- 4. • TEST: • Ask the patient to walk on narrow track or turn quickly .He/she can done this function.
- 6. Cerebellar Disorders ADIADOCHOKINESIA Or Dys- diadockinesia (A- dia -doc- kinesia ) • It means loss of repeated alternate movements. • Abnormalities in diadochokinesia can be seen in the upper extremity, lower extremity and in speech. The deficits become visible in the rate of alternation, the completeness of the sequence, and in the variation in amplitude involving both motor coordination and sequencing. • .
- 7. • Patient is not able to pronate or supinate fore arm rapidly and repeatedly • TEST: Ask the person to tap your palm with his finger tips as fast as possible HE WILL NOT ABLE TO DO THIS.
- 8. Cerebellar Disorders . Asynergia : ( Lack of coordination of movements) • Lack of coordination among various muscle groups during the performance of complex movements, res ulting in lossof skill and speed. When severe, results in decomposition of movement, wherein complex m otor acts are performedin a series of isolated movements
- 9. • It is checked by certain tests. • A . Finger-Finger • Test: • Ask the person to touch the tips of his own index finger with extended arm, bringing them rapidly close to each other.
- 10. Cerebellar Disorders . Asynergia : ( Lack of coordination of movements) • B. Finger-Nose Test: • You are doctor. Place your hand about 2 feet away from patient having cerebellar dysfunction and ask him to touch your index finger and then touch his own nose rapidly.
- 11. Cerebellar Disorders . Asynergia : ( Lack of coordination of movements ) • Romberg’s Sign: • Ask the person to stand with his feet close together with open eyes. The person with cerebellar disorder can not do this.
- 12. Cerebellar Disorders Abnormal Posture • It occur in unilateral cerebellar lesions. Head is bent towards the side of lesion and shoulder of same side is dropping.
- 13. Cerebellar Disorders Atonia / Hypotonia • Loss of muscle tone is called “ atonia ” Decrease muscle tone is called “ hypotonia ” • Hypotonic patients may display a variety of objective manifestations that indicate decreased muscle tone. Motor skills delay is often observed, along with hypermobile or hyperflexible joints, drooling and speech difficulties, poor reflexes, decreased strength, decreased activity tolerance, rounded shoulder posture, with leaning onto supports, and poor attention.
- 14. Cerebellar Disorders Nystagmus • Nystagmus is a term to describe fast, uncontrollable movements of the eyes that may be: • Side to side (horizontal nystagmus) • Up and down (vertical nystagmus) • Rotary (rotary or torsional nystagmus)
- 15. • There are two forms of nystagmus: • Infantile nystagmus syndrome (INS) is present at birth (congenital). • Acquired nystagmus develops later in life because of a disease or injury.
- 16. Cerebellar Disorders Scanning Speech • Person speak slowly and deliberately with cerebellar disorder eg . • Ask the patient to say “Artillery” He will pronounce it “ Ar —till— ler –y”
- 17. Cerebellar Disorders Intentional Tremors • Cerebral lesion shows the intentional tremors eg . • Ask the person to pick up certain object, the tremors appear in his hand, indicates cerebellar dysfunction.
- 18. Cerebellar Disorders Past pointing • It means that person is not able to achieve the goal. • Hold some object in front of patient. Ask him to touch it quickly. The patient can not do it and he overshot the aim.
- 19. Cerebellar Disorders Pendular Knee Jerk • If we elicit the knee jerk, the leg shows pendular movement, if the patient sit on bed.
- 20. Cerebellar Disorders Drunken Gait(Reeling Gait) • Patient walk just like the drunken man. Head tilted towards the lesion or he fall towards that side.
- 21. • If some of these tests are positive then we can conclude that cerebellar lesion is present.
- 22. • Cerebellar lesion may be occur due to: • Senile degenerative changes. • Cerebellar Ischemia of Infarction Injury to cerebellum • Viral infection Due to the toxin produed by bacteria or toxin present in blood due to any reason.
- 23. Management • Postural stability • Balance training • Strengthening • Stretching/Flexibility