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A detailed study.
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Cerebellar disorders
Some activities require MORE COORDINATION
Relevant Points in the HISTORY:
- Frequent falls- Clumsiness & difficulty with fine
coordinated movements- Tremors- Waxing & Waning of symptoms—MS- Stroke-- Drug toxicity: Phenytoin, alcohol
abuse, lead poisoning & solvent abuse- History of HYPOTHYROIDISM- F.H--------FA & other hereditary ataxias
SIGNS
HYPOTONIA
Cerebellar Ataxia
a b c
d
Causes: 1-Inhereted
• Autosomal recessive • Progressive degeneration of dorsal root ganglia,
spinocerebellar tracts, corticospinal tracts and cerebellar Purkinje cells.
• Chromosome 9q13• Fraxatin • Progressive difficulty in walking occurs around
the age of 12. Death is usual before 40.
• ataxia of gait and trunk• nystagmus (25%)• dysarthria• absent lower limb joint position and vibration
sense• absent lower limb reflexes• optic atrophy (30%)• pes cavus• cardiomyopathy.
ATAXIA TELANGIECTASIA
2.DEVELOPMENTAL
• ARNOLD-CHIARI MALFORMATION
• BASILAR INVAGINATION
• CEREBRAL PALSY
• BLOOD SUPPLY• Superior surface-SUPERIOR
CEREBELLAR Branch of BASILAR Artery
• Inferior surface– Anterior part: ANTERIOR INFERIOR CEREBELLAR
Branch of BASILAR Artery
• Inferior surface—Posterior part: POSTERIOR INFERIOR CEREBELLAR Branch of VERTEBRAL Artery
• VEINS: Straight sinus, Occipital sinus, Transverse sinus
3-VASCULAR
The Cerebellum is supplied by 3 major arteries on each side:
1. PICA…..The MOST common syndrome: Lateral Medullary syndrome….Wallenberg's
2. AICA, the second most common syndrome
3. SCA; the least frequent syndrome
Wallenberg's Syndrome is typified by:• Vertigo • Ipsilateral hemiataxia • Dysarthria• Ipsilateral Horner's Syndrome (Central)• Most patients with this stroke recover very well and often resume their
previous activities• Diagnosis is generally via MRI
Infectious:- Abscess- Acute cerebellitis---VIRAL- Creutzfeldt-Jacob disease
Metabolic:- Antiepileptic drugs- CO poisoning- Alcohol……vitamin B1
deficiency - Lead poisoning
4.Tumours
If you are allowed to perform ONE investigation, which one you choose in a Pt with a suspected cerebellar lesion?
…… MRI…………...