)-( LECTURE NO

Neuro-Physiology
Kamal Mohammed
Lecturer Of Physiology

Neocerebellar
syndrome

Faculty Of Medicine Head Dept.Of Physiology

 Manifestations
1. Hypotonia:
• with subsequent pendular knee jerk.

• there is muscle weakness because there is

difficulty in maintenance of muscle
contraction.
Motor (cerebellar) ataxia
 2. Motor (cerebellar) ataxia is manifested by:
1-Dysmetria:
• Definition: inability to adjust the movements
to a certain distance.
• Types:
a. Hypermetria: overshoot of movement.
b. Hypometria: stop short before its aim.
• Cause: failure of damping and timing
functions of the cerebellum.
• Examination: by finger to nose test.
 2-Dysarthria:
• Definition: difficulty in producing clear
speech, due to failure of smooth progression
and prediction of movements in muscles of
larynx, mouth, and respiratory muscles.
• Characters: the volume of sound is not
controlled; it is either loud or weak speech
with tendency to hesitate at the start of word
(as Aaa..lll.eee.xxx..aanddria).
 3-Disturbance in gait:
• the patient walks in a zigzag manner and tend
to fall toward the affected side.
 3-Dysdiadokokinesia (adiadokokinasia
):
• Definition: it is the inability to perform
rapidly alternate opposite successive
movement like supination and pronation.
• Cause: failure of predictive and smooth
progression function of the cerebellum.
 4-Decomposition of movement:
• Definition: the patient has difficulty in
performing simultaneous movements at more
than one joint.
• Character: patients dissect the movements
and carry them one joint at a time.
• Examination: by heel – knee test
 5- Rebound phenomenon:
• Definition: an overshooting of a limb when a
resistance to its movement is removed.
• Normally: flexion of the forearm against
resistance is checked when the resistance is broken
off.
• In cerebellar disease: the patient cannot stop
movement of the limb and the forearm flies
backward.
• Cause: inability to stop the movement.
 6-Kinetic (intention) tremor:
• Definition: when a person performs a
voluntary act, the movements oscillate back
and forth at the intended point, because
overshooting of the movement at the intended
point cause the motor cortex to correct the
overshooting by an opposite movement, which
again overshoot to the other side.
• Characters:
i. It continues until the movement finally settles
to the intend mark.
ii. It appears when the patient performs
voluntary action.
iii. It is absent at rest.
 7-Cerebellar nystagmus:
• Involuntary, rapid oscillation of the eyeballs in
a horizontal, vertical, or rotary direction, with
the fast component maximal toward the side of
the cerebellar lesion.
• secondary to tremors in extraocular muscles.
 Testing of coordination of voluntary
movements
1-Eyes open or closed:
I. Cerebellar ataxia is not improved by visual
orientation.
II. Sensory ataxia (from dorsal column disease)
is worsened with closed eyes.
Thanks