Cerebellar signs

Introduction The cerebellum is located above the medulla of the posterior cranial fossa, the dorsal side of the brain stem, and the ventral side of the occipital lobe of the cerebral hemisphere, covered by the cerebellum The cerebellum is divided into two parts: the cerebellum and the cerebellar hemisphere. According to the order in which the germline occurs, the cerebellum is divided into the ancient cerebellum, the old cerebellum, and the new cerebellum. Cerebellar signs are signs of cerebellar damage, such as nystagmus, decreased muscle tone, and ataxia.

Cause

1. Trauma: Cerebellar trauma is more common in brain trauma, and cerebellar trauma is mostly cerebellar penetrating injury. The symptoms of cerebellar trauma are mostly concealed by coma.

2. Cerebrovascular disease: cerebellar hemorrhage caused by rupture of the dentate nucleus of the cerebellum, causing destructive symptoms and signs of the cerebellum of the posterior half. The lesion has ipsilateral upper and lower extremity cerebellar ataxia, decreased muscle tone, and weakened or disappeared.

3. Tumor: Symptoms and signs of increased intracranial pressure and bilateral abducens nerve palsy may also occur in cerebellar hemisphere tumors.

4. Degenerative lesions: cortical atrophy of the cerebellar hemisphere and ankle, degeneration and reduction of nerve cells, the first symptoms prominently manifested as standing and walking instability, mild speech disorder.

5. Infection: Acute encephalitis caused by viral infection, acute cerebellar ataxia.

6. Poisoning: Cerebellar ataxia can occur in acute alcoholism and long-term use of larger doses of phenytoin.

an examination

Related inspection

General film examination, counterattack, brain CT examination, rebound test, beat test

The symptoms of cerebellar loss are as follows:

1. Ataxia: due to the lack of cerebellar regulation, the patient is unstable, shaking, and gait is unstable. It is a drunken gait: when walking, the legs are far apart, swinging left and right, and the upper limbs are flexed and stretched as if they would fall. . It is difficult to stand still. Generally, you cannot stand with one foot, but blinking or closing your eyes has little effect on the stability of standing. An abnormal handwriting is also a manifestation of the dissonance of the arms and hands. The writing is irregular and the strokes are trembled. Generally speaking, the writing is too large, and the tremors and numbness are mostly too small to write.

2. Outbreak language: manifested as slow speech, pronunciation, monotony, nasal. There is a similar "language of medullary lesions", but the latter is more peculiar and stupid, and objective examination often has vocal cords or soft numbness, while cerebellar speech is a joint dyskinesia with no paralysis.

3. Bad distance or scale obstacles.

4. Rotational obstacles.

5. Synergy barriers.

6. Counterattack.

7. Eyeball tremors.

8. Muscle tone changes: changes in muscle tone are more difficult to estimate.

It varies depending on the lesion and the period of the lesion, such as:

1 side of the cerebellar lesions (trauma, tumor), typical ipsilateral half-body muscle tension decreased.

2 bilateral symmetry cerebellar lesions, generally no significant changes in muscle tone.

3 Some cases of cerebellar atrophy can be seen with progressive increase in whole body muscle strength, which can be similar to tremor paralysis.

Differential diagnosis

Cerebellar dysfunction needs to be identified as follows:

Cerebellar hemisphere

Signs on the ipsilateral side of the lesion, manifested as ataxia, poor positioning, rotation movement disorder, counterattack signs, etc., and may have ipsilateral limb muscle tension, sputum reflexes and so on.

Tooth nucleus

If the lesion is limited to the dentate nucleus (especially the dentate nucleus with the lower olive), the most common symptoms are excessive exercise and rhythmic movement disorders (myoclonus). Occasionally, the muscle tension is too high. Isolated dentate nucleus lesions (or combined with one side of the binding arm) are generally ipsilateral curved tremors (or intentional tremors).

3. Cerebellar white matter and cerebellum feet

Multiple sclerosis damages the cerebellar white matter and cerebellar foot, causing intentional tremor, ataxia and blasting language.

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