The Cerebellum

Bianca Ching CN 02

Kristin Te CN 24

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

Functions

Main Motor Functions :

1) Coordination

2)Speed and smoothness of movements

3)Walking or gait

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).

Cerebellar Dysfunction

Incoordination (ataxia)

Inability to walk

Instability of the trunk (titubation)

Slurred speech (dysarthria)

Two Distinguishable Cerebellar Syndrome

Midline

Hemispheric

Midline

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.

Two Distinguishable Cerebellar Syndrome

Midline Disturbances

causes "trunkal ataxia" a syndrome where a person is unable to sit on their bed without steadying themselves

often affect eye movements; there may be nystagmus, ocular dysmetria and poor pursuit.

Two Distinguishable Cerebellar Syndrome

Hemispheric

characterized by incoordination of the limbs, there may be decomposition of movement, dysmetria, and rebound, dysdiadochokinesis is the irregular performance of rapid alternating movements.

Two Distinguishable Cerebellar Syndrome

Hemispheric

Intention tremors may be present on an attempt to touch an object. A kinetic tremor may be present in motion.

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.

Speech may be dysarthric, scanning, or have irregular emphasis on syllables.

Two Distinguishable Cerebellar Syndrome

Sources of Cerebellar Injuries

1. Toxins (ethanol, chemotherapy, anticonvulsants, ethanol).

2. Autoantibodies (paraneoplastic cerebellar degeneration )

3. Structural lesions (strokes, MS, tumors, etc)Inherited cerebellar degenerations

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.

Ataxia Ataxia comes from the Greek a taxia, meaning

literally "no order". 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.

What is Ataxia?

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" 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.

Ataxia

Kinds of Ataxia Hereditary ataxia can be separated into

types caused by a metabolic defect.

They are inherited from a defective gene, and the identification of these genes continues at an encouraging pace.

Hereditary Ataxia

Hereditary Ataxia

Some of the many types of hereditary ataxia include:

Machado-Joseph disease

ataxia with opthalmoplegia, spinopontineatrophy

ataxia with etinopathy

slow-eye movement ataxia

Kinds of Ataxia

Sporadic Ataxia

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.

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.

Kinds of Ataxia

a disturbance of body equilibrium in standing  or walking, resulting in an uncertain gait and trembling, especially  resulting from diseases of the cerebellum.

What is Titubation?

Titubation

Causes of Titubation

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. 

1. Space-occupying lesions

2. Cerebellar Lesions

3. Multiple Sclerosis (MS)

4. Pelizaeus-Merzbacher Disease

Titubation

Causes of Titubation

5. West Syndrome (Infantile Spasms)

6. Rett Syndrome

7. Guillain-Barre Syndrome

8. Friedreich's Ataxia (FRDA)

9. Cerebrospinal Fluid

10. Meningitis

11. Complications of HIV Infection

Titubation

What is Dysarthria?

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.

Dysarthria

Causes of Dysarthria

Some causes of dysarthria include stroke, head injury, cerebral palsy, and muscular dystrophy. Both children and adults can have dysarthria.

Dysarthria

Symptoms of Dysarthria

"Slurred" speech

Speaking softly or barely able to whisper

Slow rate of speech

Rapid rate of speech with a "mumbling" quality

Limited tongue, lip, and jaw movement

Drooling or poor control of saliva

Dysarthria

Abnormal intonation (rhythm) when speaking

Changes in vocal quality ("nasal" speech or sounding "stuffy")

Hoarseness

Breathiness

Chewing and swallowing difficulty

Dysarthria

Symptoms of Dysarthria

That’s Up! :)

P.S. If you are currently experiencing those symptoms, please see your physician!:)

Health is Wealth!