Causes of a cerebellar syndrome
- alcoholism – truncal ataxia
- Primary Cerebellar Neoplasm – hemangioblastoma
- Trauma – e.g. boxers
- Stroke – unilateral: PICA, SICA, AICA
- Hidden carcinoma – paraneoplastic syndrome
- Herpes Varicella-Zoster infection
- Drugs – Dilantin (anticonvulsants)
- Multiple Sclerosis
- Arnold-Chiari malformation
- Endocrine – myxoedema, hypoglycaemia
Gross Functional Anatomy
| Vermis | coordination of proximal limb and trunk |
| Flocculonodular lobe | balance and vestibulo-ocular reflexes |
| Intermediate hemispheres | coordination of distal, appendicular, limb |
| Lateral hemispheres |
motor planning for extremities |
Manifestations of a Cerebellar syndrome (“VANISHED”)
- Vertigo
- Ataxia
- Nystagmus
- Intention tremor
- Slurred or staccato speech
- Exagerrated (broad-based) gait
- Hypotonic reflexes
- Dysdiadochokinesia
| PICA | AICA | SICA | |
| Brainstem | Lateral medulla | Lateral pons (inferior) | Lateral pons (superior) |
| Cerebellum | Inferior half | Middle peduncle | Superior peduncle |
| Inferior vermis | Ventral strip, incl. flocculus | Superior hemispheres, incl. deep nuclei and vermis | |
| Syndromes | Ipsilateral Horner’s Ataxia (inf. peduncle) Dysphagia and hoarseness (nucleus ambiguous) Nausea, Vertigo, Nystagmus (vestibular nuclei) Ipsilateral (trigeminal nucleus) or contralateral facial hypoesthesia Palatal myoclonus with reduced taste sensation (nucleus solitarius) |
isolated ipsilateral ataxia (i.e. without other brainstem findings) |
Downloads
Consensus Paper: Revisiting the Symptoms and Signs of Cerebellar Syndrome – Bodranghien (2016)
Objective Assessment of Cerebellar Ataxia: A Comprehensive and Refined Approach – Kashyap (2020)
