clinical features of cerebellar disease
Last reviewed 10/2023
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