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The document summarizes various primary manifestations of cerebellar symptoms including hypotonia, ataxia, dysarthria, and ocular dysfunctions. It provides details on testing for each symptom such as using the Ashworth scale to test for hypotonia in adults and observing pronator drift. For ataxia, it lists tests like finger-to-nose coordination and heel-to-shin rubbing. Kinetic tremors are also discussed as well as non-motor manifestations like spatial dysgraphia and cognitive issues.

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

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Presentation1

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