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Saturday, August 20, 2011

Cerebral Disorders


Normal cerebellar function
Responsible for muscle synergy (coordination) throughout the body
Coordinates the action od muscles and times their contraction à movement smoothly and accurately
As a monitor of other center of the brain (not the iniator!)
The modulator (regulator) of motor activities; integrated with :
          Vestibular system (maintain muscle tone and equilibrium)
          General proprioceptive and exteroceptive receptors
          Auditory and visual system
Basically a somatic afferent organ !!
          Neocerebellum
        Dysmetria –inability to stop the movement at the desired point (overshoots or stops before it is reached)
        Intention tremor – evident during purposeful movement, but absent/diminished with rest. Titubation : rhytmic tremor iof the head, 3-4x/minute- lesion in the midline of cerebellum
        Postural disturbance
        A/dysdiadochokinesis - inability to stop a movement and follow it immediately by directly opposite action
        Hypotonia – ipsilateral to the lesion site; loss of cerebellar facilitation to the stretch reflex
        Eye disturbance : skew deviation and nystagmus (also occurred in vestibular lesion and its connections)
        Disturbance of articulation and phonation : scanning speech/stacatto
        Gait disturbance : cerebellar ataxia (tend to fall to the lesion site)
          Paleocerebellum
        Symptoms and signs of postural and muscle tone disrturbance
          Archicerebellum
        Truncal ataxia (swaying while sitting)
        Vertigo
          Equilibratory coordination - maintanance of balance and the coordination of the body as a whole; examination of station and gait
        Truncal ataxia, titubation
        Romberg sign, Walk tandem
          Non-equilibratory coordination – ability to carry out discrete, relatively fine, intentional movement with extremities.
        Dysmetria, Dysdiadochokinesia
        Nose-to-finger test, finger-to-finger test, heel-to-knee-to-toe test
        Rebound test, test pointing and past pointing
        Functional test : button-unbuttoning, writing, picking coin at desk

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