top of page

Cerebellar Disorders

Causes

  • Posterior Circulation Stroke

  • MS

  • SOL

  • Multiple system atrophy

  • Toxins and Drugs – Phenytoin, Alcohol, Lithium, Carbamazepine

    • Phenytoin is used for seizure prevention, but tends to be changed if the patient displays signs of cerebellar toxicity

  • Metabolic – Thyroid, B12 deficiency, Wilson’s disease

  • Inherited - Friedreich ataxia


Clinical Features

DANISH:

  • DDK and Dysmetria (past-pointing)

  • Ataxia (Limb/Truncal – Broad-based, unsteady gait)

    • Romberg’s +ve in cerebellar disease - Romberg’s +ve indicates sensory ataxia, therefore a sign of Dorsal column disease

  • Nystagmus

  • Intention tremor

  • Speech (Dysarthria) – Slurred/Staccato

  • Hypotonia and reduced power


Romberg's tests for ataxia, and a +ve sign is indicative of sensory or cerebellar ataxia. In cerebellar ataxia, the patients are unstable in both stages of having their eyes open and closed. When their eyes are closed, they tend to tilt toward the diseased side of the cerebellum.

The presentation differs with the location of the cerebellar lesion:

  • Cerebellar vermis typically causes truncal ataxia and gait instability, with few cerebellar signs in the limbs

  • Cerebellar hemisphere will cause signs in the ipsilateral limb



bottom of page