Cerebellar Disorders Function: Integrates (sensory And Other Information From

Cerebellar Disorders Function: Integrates (sensory and other information from multiple regions of cortex, brainstem, and spinal cord) Vision, Proprioception, Muscle Strength, Muscle Tone, Vestibular, Pressure • Uses inputs to partitipate in motor planning • Coordinates ongoing movements Lateral Hemisphere: Motor planning Extremities, lateral corticospinal tract Intermediate Hemisphere: Distal Limb Coordination, lateral corticospinal tract, rubrospinal tract Vermis/Flocculonodular Lobe: Proximal limb/trunk movements; Anterior corticospinal tract etc.. Balance/VOR reflex, medial longitudinal fasiculus CEREBELLAR DYSFUNCTION: INCOORDINATION 1.Appendicular Ataxia – difficulty with smoothy coordinated movements: Agonist/Antagonist Muscles aren’t coordinated; jerky movements; IPSILATERAL TO LESION 2. Dysdiadochokinesia-imparied repetitive movements (supination/pronation) IPSILATERAL TO LESION 3. Titubation (truncal ataxia)- difficulty maintaining upright posture: Agonist/antagonist muscles of Trunk; jerky head/thorax *LESION VERMIS/FLOCCULONODULAR LOBE 4. Impaired Suppression of VOR- jerky eye movements/blurred vision fixation on moving object due to intermittent triggering of VOR *VOR maintains fixation on stationary object while head is moving; VOR suppressed by VERMIS when watching a MOVING object to fixate and keep focus even if you are moving. (hitting baseball)*MIDLINE CEREBELLAR LESION 5. Gait Imbalance- wobbly/erratic gates leg ataxia/ impaired VOR supression 6. Scanning Dysarthria- syllables are clipped and can not put words togetherNot Aphagia! Can communicate Slow speech 7. Decreased Muscle Tone/ Decreased Reflexes Cerebellar Disorders: Tumor (Cerebellar), Stroke (PICA, AICA, SCA), Hemorrhage, Infection (abscess), Atropy (EtOH) 1.Suddent Onset of Unilateral Ataxia (Ipsilateral to

Basal Ganglia Disorders Direct Pathway: Stimulates Thalamus Movement Lesion: Hypokenisis Indirect Pathway: Inhibits ThalamusInhibits Movement Lesion: Hyperkenisis (Globus pallidus External/Subthlalamic Nucleus Sign Reversal) *Thalamus projects to motor areas in the cortex. 1. Unilateral Flapping/Flingining (Hemiballism)(Hyperkinetic, Indirect Pathway, Contral lateral Lesion in Subthalamic Nuclei) 2. Irregular Jerking Movements/Marital Problems; decrease tone (Hyperkinetic, Indirect Pathway, Decreased Size of Caudate)Huntingtons Disease 3. Assymetrical resting tremor, rigidity, bradykinesia, gait difficulties , decreased facial Expression(Hypokinesia, Direct Pathway) Parkinson’s Huntington’s Disease: Atrophy of Basal Ganglia; Progressive disease; Autosomal Dominant; Involuntary movements: chorea(dance like movements), athetosis (movement hands/feet); Memory loss +cognitive dysfunction; psychiatric disturbances (Indirect pathway/Hyperkinetic) Parkinson’s Disease: Hypokinetic, Lesion in Direct Pathway , Decrease in Dopamine in Substatia Nigra compacta. Treatment: Dopamine 1. Tremor at Rest 2. Rigidity 3. Bradykinesia Stereotactic Surgery: Surgery to correct movement 1)Bradykinesia correction via indirect pathway (Pallidotomy: Globus pallidus; Subthalamic N,) 2) Severe Tremor/Hyperkinesia correction via direct pathway (Thalamotomy: Thalamus) Stereotactic Surgery: Option for Bradykinesia/RigidityDeep Brain Electric Stimulation (inhibition Subthalamic Nucleus) Less inhibition=more movement

lesion) 2. Walking like Drunkard(fall Ipsilateral to lesion) 3. Head turns toward the direction of the lesion = blurriness of vision