COMMON CAUSES OF CEREBELLAR SYNDROMES
Acute (hours to days)
Cerebellar infarcts (Wallenberg / PICA syndrome)
Cerebellar hemorrhage
Encephalitis
Phenytoin toxicity
Subacute (weeks to month)
Alcohol abuse
Metastases
Paraneoplastic syndromes
Multiple sclerosis
Chronic (months to years)
Hereditary cerebellar degenaration (spinocerebellar ataxia)
=================
SHORTCASE
=================
--------
Notes
--------
Unsteadiness + broadbase gait
= ?cerebellar OR ?vestibular OR ?proprioceptive
Vestibular
nystagmus; no other definite cerebellar signs; romberg negative
Proprioceptive
cerebellar sign may present; typically worse when eyes closed; romberg positive
Cerebellar
cerebellar signs; romberg negative
Acute (hours to days)
Cerebellar infarcts (Wallenberg / PICA syndrome)
Cerebellar hemorrhage
Encephalitis
Phenytoin toxicity
Subacute (weeks to month)
Alcohol abuse
Metastases
Paraneoplastic syndromes
Multiple sclerosis
Chronic (months to years)
Hereditary cerebellar degenaration (spinocerebellar ataxia)
=================
SHORTCASE
=================
UPPER LIMB (4)
1. arms outstretched and eyes closed --> limb of affected side DRIFT AWAY
2. arms outstretched, same level, quick push downward --> affected side REBOUND
3. finger-nose test --> INTENTIONAL TREMOR + DYSMETRIA
4. rapid alternating movement --> DYSDIADOCHOKINESIA
HEAD (3)
1. Eye --> HORIZONTAL NYSTAGMUS (> when look toward affected side)
2. Speech --> SCANNING/STACCATO
3. Head --> TITUBATION
TRUNK (1)
1. Sit patient up without support --> TRUNCAL ATAXIA
LOWER LIMBS (2)
1. Heel-shin test --> DYSMETRIA + INTENTIONAL TREMOR
2. Knee reflex --> PENDULAR KNEE JERK
GAIT (2)
1. Walk --> BROAD BASE + REEL TOWARD AFFECTED SIDE
2. Rombergs test --> NEGATIVE (in cerebellar disorders)
1. arms outstretched and eyes closed --> limb of affected side DRIFT AWAY
2. arms outstretched, same level, quick push downward --> affected side REBOUND
3. finger-nose test --> INTENTIONAL TREMOR + DYSMETRIA
4. rapid alternating movement --> DYSDIADOCHOKINESIA
HEAD (3)
1. Eye --> HORIZONTAL NYSTAGMUS (> when look toward affected side)
2. Speech --> SCANNING/STACCATO
3. Head --> TITUBATION
TRUNK (1)
1. Sit patient up without support --> TRUNCAL ATAXIA
LOWER LIMBS (2)
1. Heel-shin test --> DYSMETRIA + INTENTIONAL TREMOR
2. Knee reflex --> PENDULAR KNEE JERK
GAIT (2)
1. Walk --> BROAD BASE + REEL TOWARD AFFECTED SIDE
2. Rombergs test --> NEGATIVE (in cerebellar disorders)
--------
Notes
--------
Unsteadiness + broadbase gait
= ?cerebellar OR ?vestibular OR ?proprioceptive
Vestibular
nystagmus; no other definite cerebellar signs; romberg negative
Proprioceptive
cerebellar sign may present; typically worse when eyes closed; romberg positive
Cerebellar
cerebellar signs; romberg negative
8 comments:
Pneumonic : DASHING PR -dysdiadokinesia -ataxia (central) -scanning speech ( ask pt to pronounce:Persatuan peladang2 Pulau Pinang) -hypotonia -intentional tremor -nystagmus -gait (broad base) P-pendular jerk . R-Rebound phenomenon
Make sure korang tau how to examine parkison k ;)
mnemonic,bukan pneumonic (as in pneumonic changes in xray),any way thanks for the refreshment guys..it helps a lot..^^
typing errorlah..
haa..sape bleh tlg post untuk parkinson plak ? :D
nystagmus pon cerebellar kn?
so dashing prn la..huhu
hehe.. takpe..add je mana yang kurang..
tapi bahaya jugak mnemonic sebab tak ikut susunan untuk examine.. lainla kalau boleh susun huruf mnemonic tu btol2 ikut susunan macam nak examine real patient..
lain org lain cara :)
Heel-shin test --> Dyssynergia
toe to finger test --> Dysmetria and intention tremor
Post a Comment