Cerebellar Disease

Question 1

Causes:

Acquired - list a few

Answer 1

Stroke
Tumour 
MS
Nutritonal - low thiamine, vit E 
Infection - VZV, HSV1
Toxins - alcohol, heavy metals

Question 2

S+S:

Are sym ipsi/contra?

DANISH mneumonic for symptoms

Answer 2

Ipsilateral to the lesion

Dysdiadokokinesia

Ataxia - limb or truncal

Nystagmus

Intention tremor and dysmetria

Slurred speech - dysarthria and/or scanning speech - slow with separated syllables

Hypotonia

Question 3

If ataxia is worse with eyes closed, what does that indicate?

What 3 ways can the nystagmus present?

Answer 3

The lesion is a dorsal column lesion - sensory ataxia, not cerebellar

Horizontal
Vertical
Rotational

Question 4

Why is the brainstem important to think about?

Answer 4

Afferent and efferent pathways to the cerebellum pass through the brainstem, so brainstem lesions will often produce cerebellar signs as well cranial nerve signs and a range of motor and sensory problems throughout the body.

Possible causes are MS, stroke or tumours