Neurology · MU Sofia

8. Cerebellum: anatomy, physiology, cerebellar symptoms and syndromes

Covers the cerebellum's role in coordinating, timing and correcting movement, with its midline vermis and lateral hemispheres and the three functional divisions set out in a table. Goes on to the peduncular connections to the brainstem, the physiological functions, and the cerebellar symptoms summarised by the DANISH mnemonic. Ends with the three cerebellar syndromes and the bedside tests used to examine cerebellar function.

Inside: 1 section · 1 table · 17 flashcards · 2 min

Topic 8 of 88 in the MU Sofia syllabus for Neurology (Medicine, Year 4). The free AceMed note covers it in 1 section, about 295 words (2 min of reading), with 17 flashcards.

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  1. Cerebellum - anatomy, physiology, cerebellar symptoms and syndromes

Cerebellum - anatomy, physiology, cerebellar symptoms and syndromes

Cerebellum

The cerebellum is responsible for the coordination, precision, timing, and smooth execution of movements. It does not initiate movement but regulates and corrects ongoing motor activity.

Anatomy

Parts of the Cerebellum

1. Vermis (midline): Controls posture and trunk movements

2. Cerebellar Hemispheres: Control coordination of ipsilateral limbs

Functional Divisions

Connections

The cerebellum is connected to the brainstem through:

  • Superior cerebellar peduncle
  • Middle cerebellar peduncle
  • Inferior cerebellar peduncle

Physiology

Functions

  • Coordination of voluntary movements
  • Maintenance of posture and balance
  • Regulation of muscle tone
  • Motor learning
  • Coordination of eye movements
  • Correction of movement errors

Important: Cerebellar lesions produce ipsilateral signs because cerebellar pathways cross twice.

Cerebellar Symptoms " DANISH"

1. Dysmetria: Inability to judge distance or range of movement.

  • Manifestations: Hypermetria (overshooting target). Hypometria (undershooting target)
  • Test: Finger-to-nose test.

2. Dysdiadochokinesia: Inability to perform rapid alternating movements.

  • Test: Rapid pronation-supination of hands.

3.Ataxia: Loss of coordination of voluntary movements.

Types

  • Truncal ataxia → vermis lesion
  • Limb ataxia → hemisphere lesion
  • Gait ataxia → broad-based, unsteady gait

4. Nystagmus:Rhythmic involuntary eye movements, usually seen in vestibulocerebellar lesions.

5. Intention Tremor: Tremor appears during voluntary movement and increases near the target. Absent at rest (unlike Parkinson tremor).

6. Scanning (Ataxic) Speech: Slow, irregular, explosive speech with abnormal rhythm.

7.Hypotonia: Reduced muscle tone on the affected side.

8. Rebound Phenomenon: Inability to stop a movement after sudden removal of resistance.

Cerebellar Syndromes

1. Cerebellar Hemisphere Syndrome

Features: Ipsilateral limb ataxia. Dysmetria. Intention tremor. Dysdiadochokinesia. Hypotonia

2. Vermian Syndrome

Features: Truncal ataxia. Broad-based gait. Difficulty standing or walking. Postural instability

3. Vestibulocerebellar Syndrome

Features:;Disequilibrium. Nystagmus. Vertigo. Gait disturbance

Examination of Cerebellar Function

Coordination Tests: Finger-to-nose test. Heel-to-shin test. Rapid alternating movements

Balance and Gait: Observe gait. Tandem walking (heel-to-toe)

Speech Examination: Assess for scanning speech

Eye Examination: Look for nystagmus

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