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clinical features of cerebellar disease

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The clinical features of cerebellar disease are:

  • from unilateral hemisphere damage - ipsilateral signs:
    • intention tremor - increases as limb reaches target
    • dysdiadochokinesis - alternating hand, heel-knee-shin
    • dysmetria - overshooting in finger-nose test
    • ataxia of extremities - unsteadiness of gait towards side of lesion
    • pendular reflexes - legs swing back and forth when knee jerk elicited
    • rebound phenomena - outstretched arm swings excessively when displaced

  • from damage to midline structures:
    • disturbance of equilibrium - manifest as unsteadiness in walking: a drunken gait which is wide based or reeling on a narrow base; sitting - truncal ataxia

  • eye movements:
    • nystagmus - in unilateral diseases, amplitude and rate increase when looking towards the diseased side; this is an inconsistent finding
    • ocular dysmetria - overshoot when eyes voluntarily fixate

  • speech:
    • scanning dysarthria - especially with explosive speech - an inconsistent finding

  • involuntary movements:
    • myoclonic jerks and choreiform motions if deep nuclei involved

  • abnormal head tilt - also in trochlear palsy, tonsillar herniation

  • rhythmic nodding tremor of head - side to side or 'to and fro' - titubation

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