Cerebellar syndrome, as a symptom and consequence of neurological disorders. Cerebellar inflammation symptoms treatment Cerebellar diseases symptoms treatment

Cerebral ischemia is a pathological condition in which the brain lacks oxygen due to impaired cerebral circulation. Diseases develop due to constriction of the blood vessels of the brain or blockage of their lumen with blood clots.

The reasons

There are two main reasons leading to cerebral ischemia: hypertension and atherosclerosis. With high blood pressure, vasospasm occurs. Atherosclerotic changes contribute to the deposition of excess fat inside the vessels, and gradually the lumen of the blood tube narrows. A complete blockage can cause a patient’s life-threatening acute condition - ischemic stroke.

In addition, there is a group of factors in which there is a marked increase in the probability of ischemia. These include:

• cardiac muscle rhythm disorders;
• pathology of the venous bed;
• diseases of the cardiovascular system;
• genetically determined angiopathies, abnormalities of blood vessels;
• vascular compression damage;
• systemic (vasculitis) and endocrine (diabetes) pathologies;
• cerebral amyloidosis;
• blood diseases (increased viscosity).

Also contributes to the development of ischemia poisoning CO (carbon monoxide) or other volatile toxic substances.

Symptoms and types of ischemia

During cerebral ischemia, there is a violation of blood flow in many parts of the central nervous system with simultaneous focal damage to the medulla. The disease proceeds in different ways.

Transient form

The patient complains of pain in the eyeballs, headache, vomiting, sudden dizziness, slight tinnitus. Seizures and short-term loss of consciousness may occur. Intestinal motility is impaired, muscle tone decreases, legs become “wadded.” If pathological changes during ischemia occur in the middle cerebral artery, disorders of touch and speech are observed, coordination is disturbed.

Symptoms of brain ischemia of this form may disappear themselves after some time. However, they do not pass for the body without a trace: pathological processes affect the temporal and occipital lobes of the brain, the cerebellum. To avoid complications, at the first signs of ischemia, you should consult a doctor.

Acute form

Proceeds as a ischemic stroke. The clinic is bright, developing rapidly. Symptomatology depends on the localization of the pathological focus. The main signs of the disease: impaired speech, coordination, vision, weakness in the limbs, dizziness, blurred consciousness. A person cannot fully perform his usual actions: brush his teeth, wear clothes, he has memory lapses. Mandatory drug correction is required, followed by comprehensive rehabilitation.

A sharp headache, vomiting, flashing before the eyes of flies, loss of consciousness - symptoms of cerebral ischemia, with the appearance of which you must immediately call an ambulance.

Chronic form

In chronic cerebral ischemia, symptoms appear gradually. At the same time, over time, the “old” symptoms worsen, the general condition of the patient worsens.

There are 3 degrees of the disease.

The following symptoms are characteristic of grade 1 ischemia: severity and pain in the head, dizziness, fatigue, weakness, and mood swings. It becomes difficult for a person to remember something, to concentrate his attention. His sleep is disturbed.

With 2 degrees of chronic cerebral ischemia, neurological symptoms join the above manifestations of the disease. Vertigo becomes constant. The gait is broken, the patient falls into a depressive state, mental processes are inhibited, he is not able to control his actions. Emotional-personality disorders appear.

If the treatment is not performed with the above symptoms of cerebral ischemia, the pathology progresses. Its 3rd degree develops, which is characterized by motor impairment, uncontrolled urination, impaired speech, the appearance of shallow and rapid breathing. A person cannot remember how to perform basic household activities (he loses the ability to serve himself). There is a disintegration of personality. Such a patient needs external help.

Ischemia in newborns

Ischemia of the brain in a newborn is a pathology, for the treatment of grade 3 of which no effective medicinal methods have been found.

The factors provoking the development of the disease are:

• maternal diseases during pregnancy (infectious, endocrine, cardiovascular, pulmonary);
• late toxicosis;
• lack of water;
• premature (or late) labor activity;
• pathology of the placenta;
• multiple pregnancy;
• age of the woman in labor (more than 35 years, up to 18 years);
• difficult childbirth;
• the birth of a large child;
• cesarean section;
• cord entanglement;
• the use of labor induction of labor;
• the presence of a pregnant woman bad habits.

Ischemia of the brain occurs in newborns due to a violation of the placental-uterine circulation. As a result of fetal hypoxia, individual parts of the brain die.

The baby has an increased irritability, tremor, causeless crying. There is a decrease in muscle tone, a weak swallowing and sucking reflex. In some cases, there is strabismus, hydrocephalus, asymmetry of the face. In severe cases - seizures and coma.

Timely adequate treatment in the early stages can successfully combat ischemia in the newborn.

Treatment

Brain ischemia is treated by a neurologist. It takes place in the hospital. Any treatment is aimed at restoring or normalizing the blood circulation in a patient.

Drug therapy

Drug effects are aimed at restoring ischemia in the normal blood circulation and stabilizing metabolic processes in brain tissue.

Use the following groups of drugs:

• angioprotectors - drugs that stimulate metabolism and improve cerebral circulation (bilobil, nimodipine);
• vasodilators - relieve spasm of blood vessels (pentoxifylline, nicotinic acid-based products);
• nootropic drugs - contribute to the stimulation of mental activity, improve memory (cerebrosin, piracetam);
• antiplatelet agents - prevent the formation of blood clots in the bloodstream (dipyridamole, aspirin).

Treatment of ischemia lasts 2 months, courses a year - two.

Surgical treatment

Surgical intervention is indicated for grade 3 ischemia, in the absence of effect from conservative therapy. Among the most popular methods: carotid stenting, carotid endarterectomy.

Effects

Severe cerebral ischemia usually occurs in case of treatment failure in the later stages of the pathological process. These include: persistent headaches, mental retardation, isolation, inability to be in society, learning difficulties.

Timely diagnosis of ischemia and timely initiated therapy can avoid complications and irreversible processes in the brain.

Video about the prevention of cerebral ischemia:

Varieties and causes of the development of brain pathologies

The brain is the organ that regulates and coordinates the work of all systems of the human body. Due to its structure, the brain provides a harmonious interaction of other organs. The brain consists of special cells - neurons - which, through synaptic connections, generate impulses that ensure the functioning of organs. Brain diseases make impossible the full existence of the body. Because of this, it is not only human health that suffers, but also the quality of life. Most brain diseases are associated with dysfunction of the blood vessels supplying the organ.

Vascular diseases: aneurysms

Aneurysm of the cerebral vessels is a disease that threatens to hemorrhage into the cranial cavity, or hemorrhagic stroke. Aneurysm is a zonal expansion of the vessel, formed due to changes in its walls. This is a kind of “bag”, which is formed due to the separation of the vessel wall. Aneurysm is filled with blood, which is why it increases. The danger of the "bag" is not only in its sudden rupture, but also in the fact that the aneurysm itself can squeeze nerves and brain tissue.

Aneurysms are:

1. Arterial: formed mainly in the vallyseevy circle at the base of the skull. Arterial aneurysm resembles a sphere or a bag.
2. Arteriovenous: formed during weakening and deformation of the venous walls.

The factors contributing to the development of aneurysms in the vessels include:

• atherosclerosis;
• infections that can affect the walls of blood vessels (syphilis, tuberculosis);
• hypertension;
• tumors;
• smoking, alcohol abuse;
• congenital anomalies of arteries.

Symptoms of aneurysm of arteries and veins include:

• blurred vision and hearing;
• dizziness;
• amnesia;
• speech disorders;
• double vision;
• severe headaches.

The danger of aneurysm lies in the fact that it can only be detected with an accidental diagnosis (angiography, Doppler of cerebral vessels). Most patients learn about the presence of the disease only after aneurysm rupture.

Symptoms of aneurysm rupture are similar to signs of hemorrhagic stroke: loss of consciousness, dizziness, blackening of the eyes, numbness of the face (extremities), excessive sweating, nausea and vomiting may occur. In addition, the speech of the affected person becomes slurred, and his tongue becomes curved. There may also be sagging on one side of the face. The consequence of aneurysm rupture is the formation of an intracerebral hematoma. In addition, hemorrhage can block the cerebrospinal fluid pathway, and this will lead to the development of hydrocephalus and cerebral edema. Complications of aneurysm rupture include:

• cognitive impairment;
• loss of control of urination and defecation;
• difficulty swallowing;
• violation of perception and speech;
• paralysis.

In the treatment of aneurysms, preference is given to surgical methods:

• clipping the affected area of ​​the vessel;
• strengthening the walls of blood vessels;
• endovascular operations.

To prevent aneurysm rupture prescribed:

• drugs to normalize pressure;
• calcium channel blockers;
• anticonvulsant drugs.

Cerebral atherosclerosis

The essence of the disease lies in the violation of the functions of blood vessels due to the occurrence of fat deposits and connective tissue in their lumens. Such tumors are called atherosclerotic plaques. They partially close the lumen of the vessel, thereby preventing the body from supplying oxygen and nutrients. In addition, atherosclerotic plaques contribute to the formation of blood clots in the vessels, due to which the lumen can completely close. The disease affects the main and middle arteries of the brain.

Chronic hypoxia of the tissues of the body causes a gradual necrosis of their sections. This leads to the death of neurons. The occurrence of atherosclerosis affects people over 45 years old, mostly men. Hypertension, diabetes mellitus, obesity, impaired lipid metabolism and burdened heredity also act as provoking factors.

Symptoms of the disease manifests itself slowly. Symptoms of atherosclerosis resemble many signs of other brain diseases. The man notes in his:

• frequent headaches and dizziness;
• reduced concentration of attention and memory;
• insomnia or, on the contrary, drowsiness;
• reduced work capacity.

As atherosclerosis progresses, a person can suffer from micro-strokes that can threaten with paralysis. When a vessel transporting blood to the organ is blocked, ischemic disease occurs.

It is possible to diagnose the disease using laboratory blood tests, in particular, determining the level of cholesterol. Informative is magnetic resonance angiography and vascular dopplerography. Treatment of the disease is complex. Directions of therapy include:

• control of the level of cholesterol in the blood, provided a therapeutic diet;
• taking drugs that reduce cholesterol;
• taking blood thinners;
• taking iodine-containing drugs.

If there is a threat of occlusion of the vessels of the head, a decision may be made in favor of the operation. There are such types of them:

• balloon dilatation of the artery;
• stenting;
• endarterectomy.

Vascular dystonia of the brain

Vegetative dystonia is a disease accompanied by constriction of the brain's blood vessels, disruption of its blood supply and fluctuations in blood pressure. The disease has a polyetiological character, that is, it can be provoked by several factors at the same time. Vegetative dystonia develops in the background:

• prolonged psycho-emotional stress;
• traumatic brain injury;
• past infectious disease;
• hereditary factor;
• osteochondrosis of the neck;
• hormonal alteration;
• chemical exposure;
• poisoning;
• unhealthy diet;
• climate change.

The symptoms of vascular dystonia include:

• meteorological dependence;
• feeling of lack of oxygen;
• fluctuations in blood pressure;
• headaches and dizziness;
• impaired thermoregulation;
• emotional instability.

Treatment of dystonia of cerebral vessels is complex and continuous. It includes:

1. Lifestyle correction: adherence to work and rest, proper nutrition, moderate exercise, walking in the fresh air, preventing overwork.
2. Autotraining and work with a psychotherapist.
3. Drug treatment: used to eliminate the symptoms of the disease. For dystonia of the cerebral vessels, light sedatives, agents for the normalization of the cerebral circulation, vitamins and antioxidants are prescribed.

A brain tumor

Neoplasms that appear inside the skull can be benign or malignant. A tumor can form in any part of the brain. There are these types of brain tumors:

1. Benign and malignant gliomas: the most common tumors that can affect any part of the body. Benign gliomas are most common in children, and malignant - in young males. Malignant tumors provoke severe disorders of the organ, which leads to rapid death.
2. Meningiomas: benign vascular neoplasms, which have the appearance of an isolated node. Meningiomas are most common in adults. The most dangerous is the location of the tumor on the brain stem.
3. Adenomas: benign glandular tumors that form in the pituitary gland. Adenoma produces hormones, which causes a violation of the hormonal background of a person.
4. Teratomas: growing benign brain tumors. They provoke an increase in intracranial pressure and hydrocephalus.
5. Metastases: are formed due to the transportation of cancer cells from other organs, for example, the mammary glands and lungs.

The risk factors for the development of tumors in the brain include:

• unfavorable ecological environment;
• genetic pathology;
• metabolic disorders;
• disturbances in the development of the embryo;
• viral infections;
• head injuries;
• oncological diseases of other organs.

Symptoms of a tumor depend on its location:

1. Frontal lobe: impaired speech and motor function.
2. Parietal area: loss of self-care skills, lack of sensitivity.
3. Temporal area: the appearance of auditory and visual hallucinations, convulsions.
4. Occipital region: hallucinations, impaired color perception.
5. Brain stem: severe impairment of life, for example, difficulty breathing and swallowing, loss of vision and paralysis.

To diagnose a tumor, you can use:

• magnetic resonance imaging;
• electroencephalography;
• spinal puncture;
• radioisotope scan.

Treatment of the disease depends on the nature of the tumor, its location and size. There are such methods of treatment of tumors:

• neurosurgical operation;
• chemotherapy;
• radiation therapy;
• symptomatic therapy.

Other ailments

Common are degenerative brain damage:

• alzheimer's disease;
• parkinson's disease;
• pick's disease.

These diseases are characterized by organic lesions that provoke dementia, tremors of the body and limbs and lead to disability. These pathologies develop in older people, but now there is no list of the causes of these diseases. It has been found that the risk group includes people with atherosclerosis, hypertension, ischemia, and diabetes. A hereditary factor plays a special role in the development of degenerative lesions of the medulla. Treatment of degenerative processes in the brain is aimed at reducing the symptoms and counteracting the development of diseases. Today, there is no method for the complete recovery of degenerative brain lesions.

Among brain diseases, there are injuries:

• shaking;
• bruises;
• penetrating wounds of the skull.

The consequences of injuries depend on their severity and their state of health.

Infectious brain damage provoked by viruses, bacteria and fungi. Diseases of viral origin are easier than those that have a bacterial and fungal nature. Brain lesions triggered by infections:

1. Encephalitis: inflammation of the substance of the brain.
2. Meningitis: damage to the membranes of the body.
3. Arachnoiditis: inflammation of the arachnoid membrane of the brain.

Infectious diseases are dangerous because of their complications: disability, loss of self-care skills, impaired coordination, hearing, vision and speech.

Most congenital abnormalities of the brain, along with heart defects, cause death among newborns. For congenital anomalies of the brain include:

1. Microcephaly: insufficient brain volume. The disease is associated with a high percentage of survival. Sick children have low intelligence, impaired coordination and seizures.
2. Anencephaly: the absence of most of the brain. The probability of survival is low.
3. Encephalocele: protrusion of the brain through the defects of the skull. Anomaly is eliminated surgically. The disease has a favorable prognosis.
4. Hydranencephaly: absence of cerebral hemispheres. There is a low level of intelligence and developmental delay.
5. Hydrocephalus: caused by disturbed outflow of liquor and increased intracranial pressure. The disease is characterized by a rapid increase in head size.

All diseases of the brain require special attention. Self-treatment of such ailments can be not only inconclusive, but also dangerous. Neurologist, neurosurgeon and vascular surgeon are engaged in the treatment of brain diseases. For tumors in the organ, the help of an oncologist is used. Rehabilitation of patients after severe brain diseases is within the competence of a rehabilitation physician.

The main symptoms of cerebellar cerebral tumor

1. Diagnosis of the disease

Among the tumors of the cerebellum tumor occupies a prominent place. It is not necessarily malignant - sometimes benign. It is important to identify the signs of the disease in time to start treatment immediately. In this case, the delay becomes the cause of the hardest consequences.

The histological structure of cerebellar cerebral tumors is different. It is important to note that the location of the tumor sometimes becomes such that even a benign tumor is life threatening. The fact is that such a tumor provokes serious disorders of blood circulation, respiration, as it can impair the structure of the brain.

Symptoms of a tumor are focal, distant, cerebral. It is extremely important to conduct an MRI, CT scan of the brain to determine if it is a neoplasm.

More often tumors of this type need surgical treatment, that is, surgical. Today we look at the symptoms of cerebellar cerebral tumor in more detail. Let us briefly discuss the principles of treatment, diagnosis of this disease.

If we consider the mass of brain tumors, neoplasms of the cerebellum occupy 30% in it. This percentage indicates: this disease should be given maximum attention. Neoplasms are both primary and secondary.

When we speak of a primary tumor, we mean tumors, the sources of which are the lining of the brain and nerve cells. In a secondary tumor, metastases from another tumor are the cause of its occurrence.

More than a hundred types of cerebellar cerebellar tumors are isolated, if we talk about their histological structure. Most often these are cancer metastases, as well as gliomas, which are astrocytomas and medulloblastomas. In most cases, it is glioma.

Sometimes these tumors grow slowly, because they can be encapsulated, are located separately from the brain tissue. Sometimes infiltration into surrounding tissues occurs. This is also positive.

Symptoms of the disease is different. Conventionally, numerous symptoms can be divided into focal, distant and cerebral.

Focal are directly cerebellar symptoms, with distant symptoms appearing at a distance. And with increased intracranial pressure, cerebral symptoms develop.

Symptoms occur in parallel: signs from different groups are observed simultaneously. Most often such a pattern is characteristic of a growing tumor, when it already squeezes the brain structures.

In many ways, the course of the disease depends on the location of the cerebellum. It is located directly above the brain stem.

Therefore, the first signs are the symptoms indicating a serious violation of the outflow of cerebrospinal fluid. At the same time, the lesion of the tissues of the cerebellum itself is not always immediately apparent.

Cerebral signs

Briefly list the basic symptoms of cerebral type.

• Head spinning.
• There are headaches. They are localized in the neck, neck. Strengthened, appear with a certain frequency. Sometimes a sharp pain in the head is accompanied by vomiting, bouts of nausea.
• Patients suffer from nausea, vomiting, which are not associated with the work of the digestive tract. It's all about the irritation of certain centers in the brain. Typically, these symptoms are characteristic of the morning hours. They are also associated with increased intracranial pressure.
• The doctor may detect stagnant discs in the optic nerves.

When a person has these symptoms, it is extremely important to undergo the necessary examination in time to diagnose the disease. However, CT is sometimes not enough. MRI is the optimal solution for detailed brain research. Such a survey will confirm the suspicion or exclude the presence of the disease.

Such symptoms characteristic of a cerebellar cerebral tumor already correlate specifically with various lesions in the tissues of the cerebellum. The specific symptoms depend on the specific area of ​​the cerebellum that squeezes the tumor.

Sometimes the tumor begins to grow in one of the cerebellar hemispheres. As a result, the proportionality, smoothness, and accuracy of a diverse person are violated. Muscle tone falls, the patient misses.

Trembling limbs, speech disorders begin. Disturbances are often one-sided - on the side on which the tumor squeezes the cerebellar hemisphere.

When the central cerebellar worm is affected, it becomes extremely difficult for a person to stand, walk. The patient begins to swing strongly in the process of walking. Gait becomes like a drunk person, a person may suddenly fall.

When the tumor grows, it becomes harder to walk. The patient gradually loses stability, unable to keep balance. When the neoplasm squeezes the central part of the cerebellum even more, the person cannot even sit upright.

Over time, the tumor becomes more and more, it captures other parts of the cerebellum. Because of this, signs are mixed, new ones are added. The process becomes bilateral, and in the end, the central part of the cerebellum is affected.

A characteristic feature is nystagmus. This is manifested in involuntary movements of the eyeballs, which reveal when the patient looks away.

Disorders of cerebrospinal fluid outflow

Since the tumor in the cerebellum is in close proximity to the fourth ventricle, there are irregularities in the circulation of the cerebrospinal fluid. The fluid moves worse, sharply increases the pressure in the spinal cord. As a result, the patient is tormented by bouts of vomiting, nausea.

Starts strongly to rock in transport. When a person leans forward, makes sudden movements of the head, the state instantly worsens. Patients suffer from clouding, loss of consciousness, indomitable vomiting, severe headaches.

At the same time, the respiratory organs function worse, there are irregularities in the work of the heart. This is a serious threat to the life of the patient.

Infringement of cerebral tissue

The tumor gradually grows, taking up more and more space in the skull. At the same time the space inside the head is constantly. When a brain tissue is pinched by the neoplasm, the patient may die.

Thus, even a benign tumor provokes a fatal outcome, although it does not metastasize, it does not affect the entire body. It acts purely mechanically.

Also characterized by symptoms of a remote nature. They appear due to compression of the cranial nerves. They are located in the brain stem, and leave the brain tissue. When nerve roots are compressed, a number of symptoms can be identified:

Patients most often suffer from violations of self-determination of the body in space, motor disorders, as well as problems with the work of the cardiac, vascular system.

Diagnosis of the disease

It is important to conduct a thorough neurological examination. A significant role is played by the examination of the ophthalmological point of view, the study of the state of the fundus. Accurate results are obtained when using modern radiation research methods.

The correct solution is to conduct magnetic resonance imaging, while providing intravenous contrast enhancement. Only then a thorough examination will detect the tumor in the cerebellum of the brain, as well as properly separate the disease from other signs characteristic of the cerebellum.

The data obtained during MRI are invaluable when surgery is needed. The disease is treated by surgical removal of the tumor.

With cerebellar tumors, the prognosis is good only with timely removal of the tumor. The treatment is carried out mainly by surgery. It is important to radically remove all tissues affected by the tumor.

Much to my regret, it is far from always technically possible to perform such an operation. When the tumor has already captured the fourth ventricle, as well as the surrounding brain tissue, it is not possible to remove it. Then they are limited to eliminating all tumor tissues that can be removed.

It is important to restore, if possible, the normal circulation of CSF. Sometimes for this purpose it is necessary to remove partially the first cervical vertebra, part of the occipital bone. All this is necessary to prevent compression of the brain stem.

If the histological analysis has confirmed that the tumor is malignant, it is necessary to conduct a course of radiation treatment. Only such therapy gives a chance to destroy all the remaining cells of the tumor. Chemotherapy is also underway. How exactly to carry out the treatment can be found only after a thorough histological analysis.

Signs of illness also need to be fought, because they make the patient suffer greatly. To remove the symptoms, conduct drug therapy. They prescribe hormonal, firming agents, drugs against vomiting and nausea, headache and dizziness.

It is also important to deal with violations in the work of the heart, vascular system. Drug treatment does not affect the neoplasm itself, but it becomes easier for the patient.

To accurately verify the presence of a cerebellar tumor, an MRI scan is necessary. It will show the location, size, all the features of the tumor. Unfortunately, recovery cannot be guaranteed even if the tumor is removed.

From point of view anatomical location of the cerebellum   directly adjacent to the brain stem and connected to it with its three legs.
  The cortex and nuclei of the cerebellum contain ganglion cells, which perform the function of processing information and sending impulses.
  Information about the position of body parts and muscle activity enters the cerebellum through the lower leg of the cerebellum (corpus restiforme) and partially through the upper leg of the cerebellum (brachium conjunctivum).

Vestibular impulses that carry information about the position of the head in space and its movements, enter the cerebellum through the lower leg.
  Impulses coming from the large brain and having a switch in the nuclei of the bridge enter the cerebellum through the middle leg of the cerebellum (brachium pontis).
  Information that is processed in the cerebellar cortex passes in the form of pulses through the nucleus of the cerebellum (and olive), through the upper leg to the red nucleus and the ventral core of the opposite side of the thalamus. After switching in the thalamus and the red nucleus, these impulses reach the cortex of the cerebral hemispheres or, via the rubrospinal tract of the anterior horns of the spinal cord, enter the muscles. Thus, the cerebellum is included in the system of regulation, ensuring the harmony and coordination of movements.

These structures   presented in the figure. They are responsible for the flow of information on motor impulses, on the one hand, on the state of the motor apparatus, on the other, allowing the cerebellum to constantly conduct a comparative analysis of the movement plan with its implementation and monitor the motor function using the feedback mechanism. Separate parts of the body have a topical representation in the cerebellar cortex. The cerebellum is supplied with blood from the branches of the vertebral and basilar arteries (the posterior lower, anterior lower and upper arteries of the cerebellum).

Cerebellar lesions syndromes   characterized by the following common features:
  decreased muscle tone;
  the deviation of voluntary movements from a harmonious ideal line;
  violation of automatic movements.

In some cases, may the following symptoms are observed:
  Dyssynergia (lack of coordination of muscles or muscle groups involved in movement):
  dysmetry (impaired ability to correctly determine the required amplitude and rate of movement);
  ataxia (violation of the harmonious functioning of the muscles to achieve the goal of movement, resulting in a lack of accuracy and smoothness of movement);
  intentional tremor (increasing deviation from the main line of motion as it approaches the target of the movement);

Pathological re-phenomenon (if suddenly the resistance directed against a group of strained muscles disappears, the antagonist muscles do not have time to “turn on” to slow down the excess movement);
  disdiadochokinesis (fast and smooth sequential movements of agonist and antagonist muscles become impossible);
  hypotension (detected with passive movements, such as "shaking" the limb);
  deviation in the positional sample and miss in the Barani sample on the side of the focus;
  uncertainty when standing in a Romberg position;

Trunk ataxia when sitting;
  an uncertain walk with legs wide apart;
  nystagmus (especially the installation nystagmus on the affected side);
  speech disorder in the form of a fragmentary, scanned speech.

To the most frequent etiological factors of cerebellar damage   relate:
  degenerative diseases — systemic atrophies, such as olivopontocerebellar atrophy;
  genetically determined metabolic disorders (for example, Louis-Bar ataxia-telangiectasia, Hartnap disease, paroxysmal to investigative ataxia, abetalipoproteinemia or Bassen-Cornzweig disease, gangliosidosis with hexosaminidase A deficiency);
  infectious diseases, such as infectious mononucleosis (a form of acute cerebellar ataxia in children), kuru (slow viral infection);
  acute poisoning with a transient lesion of the cerebellum (for example, diphenylhydantoin);

Acquired metabolic disorders, such as hypercalcemia or cholestasis, or a condition after resection of the small intestine, accompanied by a deficiency of vitamin E;
  symptomatic atrophy (cortex) of the cerebellum with toxic damage (eg, alcohol, diphenylhydantoin, organic mercury salts), with malabsorption, for example, due to sprue, with paraproteinemia or with malignant tumors (especially bronchial carcinoma);
  multiple sclerosis (foci in the substance of the cerebellum or its pathways);
  rarely, circulatory disorders and massive hemorrhages in the cerebellum;

Foci in the area of ​​transition from the upper to the middle third of the leg of the bridge, a lesion of the cerebellum develops suddenly and is accompanied by hemiparesis;
  tumors (medulloblastoma and spongioblastoma [cerebellar astrocytoma] in adolescents, glioma, tumors of the bridge-cerebellar angle);
  abscess;
  remittent forms of lesion of the cerebellum are also described, isolated cases in multiple sclerosis and more frequent in cases of familial episodic ataxia.

Cerebellar ataxia is a disorder in the coordination of movements of various muscles, which is caused by a pathology of the cerebellum. Discordance and clumsiness of movements can be accompanied by chanted, jerky speech, a violation of the consistency of eye movements and disgraphia.

ICD-10	G11.1-G11.3
ICD-9	334.3
DiseasesDB	2218
MedlinePlus	001397
Mesh	D002524

Forms

Focusing on the lesion of the cerebellum, stands out:

• Static-locomotor ataxia, which occurs when the cerebellar worm is affected. The disorders that develop with this lesion are manifested mainly in the violation of stability and gait.
• Dynamic ataxia, which occurs with lesions of the cerebellar hemispheres. With such lesions, the function of performing voluntary movements of the limbs is impaired.

Depending on the course of the disease, cerebellar ataxia is isolated:

• Acute, which develops suddenly as a result of infectious diseases (disseminated encephalomyelitis, encephalitis), intoxication resulting from the use of lithium preparations or anticonvulsants, cerebral stroke, obstructive hydrocephalus.
• Subacute. Occurs with tumors located in the cerebellum, with Wernicke's encephalopathy (in most cases it develops with alcoholism), with poisoning with certain substances (mercury, gasoline, cytostatics, organic solvents and synthetic glue), with multiple sclerosis and with traumatic brain injury subdural hematoma. It can also develop with endocrine disorders, vitamin deficiency and in the presence of a malignant neoplastic process of extracerebral localization.
• Chronically progressive, which develops during primary and secondary cerebellar degenerations. Primary cerebellar degenerations include hereditary ataxia (Pierre-Marie's ataxia, Friedreich's ataxia, olivopontocerebellar atrophy, Nefriedreich's spinocerebellar ataxia, etc.), parkinsonism (multisystem atrophy), and idiopathic cerebellar degeneration. Secondary cerebellar degeneration develops with celiac ataxia, paraneoplastic cerebellar degeneration, hypothyroidism, chronic intestinal disease, which is accompanied by impaired vitamin E absorption, hepatolenticular degeneration, craniovertebral abnormalities, multiple sclerosis, and an area of ​​the bridge, in the area of ​​the hemorrhagic syndrome, craniovertebral abnormalities, multiple sclerosis, and an area of ​​the bridge, there is one, and there is one, there is one, and there is one, and the heart doesn’t have to be in the area with the heart, and there is one, there is one, and the heart doesn’t have to be in the area, and the heart doesn’t have to have the same pattern, I am using, I am not using the same pattern, I do not have the same, if you are using the brains, you are using a heartbeat pattern, heart failure, and there is one, there is one, there is one, and there is one, and the heart doesn’t have to have an outlet on the heart if it is imperative, it has a heart failure, heart failure, and there is one,

Separately isolated paroxysmal episodic ataxia, which is characterized by repeated acute episodes of coordinator disorders.

Causes of development

Cerebellar ataxia can be:

• hereditary;
• acquired.

Hereditary cerebellar ataxia can be caused by such diseases as:

• Friedreich's family ataxia. It is an autosomal recessive disorder characterized by degenerative damage to the nervous system as a result of an inherited mutation in the frataxin protein coding for the FXN gene.
• Zeeman syndrome that occurs with anomalies of the development of the cerebellum. This syndrome is characterized by a combination of normal hearing and child's intelligence with delayed speech development and ataxia.
• Betten's disease. This rare disease manifests itself in the first year of life and is inherited in an autosomal recessive manner. Characteristic signs are violations of statics and coordination of movements, nystagmus, disorder of eye coordination,. Dysplastic signs may occur.
• Spastic ataxia, which is transmitted by an autosomal dominant type and is distinguished by the debut of the disease at the age of 3-4 years. For this disease is characterized by dysarthria, tendon and increased muscle tone of the spastic type. May be accompanied by optic atrophy, retinal degeneration, nystagmus and oculomotor disorders.
• Feldman syndrome, which is inherited in an autosomal dominant manner. Cerebellar ataxia with this slowly progressive disease is accompanied by early graying of the hair and intentional trembling. He makes his debut in the second decade of life.
• Myoclonus-ataxia (Hunt's myoclonic cerebellar dyssynergy), which is characterized by myoclonia, first affecting the hands, and later acquiring a generalized nature, intentional tremor, nystagmus, dyssynergy, decreased muscle tone, chanted speech, and ataxia. It develops as a result of the degeneration of cortical-subcortical structures, nuclei of the cerebellum, red nuclei and their connections. This rare form is inherited in an autosomal recessive manner and usually debuts at a young age. As a result of disease progression, epileptic seizures and dementia may occur.
• Tom's syndrome or late cerebellar atrophy, which usually occurs after 50 years. As a result of progressive atrophy of the cerebellar cortex, patients show signs of cerebellar syndrome (cerebellar static and locomotor ataxia, chanted speech, changes in handwriting). Perhaps the development of pyramidal insufficiency.
• Familial cerebeloliar atrophy (Holmes cerebellar degeneration), manifested in progressive atrophy of the jagged and red nuclei, as well as demyelination processes in the upper pedicle of the cerebellum. Accompanied by static and dynamic ataxia, asynergia, nystagmus, dysarthria, decreased muscle tone and muscular dystonia, head tremor and myoclonias. Intellect in most cases is preserved. Almost simultaneously with the onset of the disease, epileptic seizures appear, and paroxysmal dysrhythmia is detected on the EEG. The type of inheritance is not set.
• X-chromosomal ataxia, which is transmitted via a recessively sex-linked type. It is observed in the majority of cases in men and manifests itself as a slowly progressive cerebellar insufficiency.
• Celiac ataxia, which is a multifactorial disease and is inherited in an autosomal dominant manner. According to recent studies, ¼ cases of idiopathic cerebellar ataxia are caused by hypersensitivity to gluten (occurs in celiac disease).
• Leyden-Westfal syndrome, which develops as a parainfectious complication. This acute cerebellar ataxia occurs in children 1-2 weeks after the infection (typhus, influenza, etc.). The disease is accompanied by rough static and dynamic ataxia, intentional tremor, nystagmus, chanted speech, decreased muscle tone, asynergia and hypermetry. Cerebrospinal fluid contains a moderate amount of protein, lymphocytic pleocytosis is detected. The disease at the initial stage may be accompanied by dizziness, disorder of consciousness, seizures. For benign.

The cause of acquired cerebellar ataxia can be:

• Alcoholic cerebellar degeneration, which develops during chronic alcohol intoxication. The lesion affects predominantly the cerebellum worm. Accompanied by polyneuropathy and pronounced loss of memory.
• Stroke, which in clinical practice is the most common cause of acute ataxia. Atherosclerotic occlusion and cardiac embolism most often result in cerebellar stroke.
• Viral infections (chickenpox, measles, Epstein-Barr virus, Coxsackie viruses and ECHO). It usually develops 2-3 weeks after a viral infection. The prognosis is favorable, full recovery is observed in most cases.
• Bacterial infections (parainfectious encephalitis, meningitis). Symptoms, especially for typhus and malaria, are reminiscent of Leiden-Westphal syndrome.
• Intoxication (occurs when poisoning by pesticides, mercury, lead, etc.).
• Vitamin B12 deficiency. Observed with a strict vegetarian diet, chronic pancreatitis, after surgical interventions on the stomach, with AIDS, the use of antacids and some other drugs, repeated exposure to nitrous oxide and Imerslund-Grosberg syndrome.
• Hyperthermia.
• Multiple sclerosis.
• Traumatic brain injury.
• Tumor formation. The tumor does not have to be localized in the brain - in malignant tumors, paraneoplastic cerebellar degeneration can develop in various organs, which is accompanied by cerebellar ataxia (most often it develops in cases of breast or ovarian cancer).
• General intoxication, which is observed in cancer of the bronchi, lung, breast, ovaries, and manifests Barracker-Bordas-Ruiz-Lara syndrome. With this syndrome, as a result, a rapidly progressing cerebellar atrophy develops.

The cause of cerebellar ataxia in people 40–75 years old may be Marie – Foy – Alajuanin’s disease. This disease with an unidentified etiology is associated with late symmetric cortical atrophy of the cerebellum, which is manifested by a decrease in muscle tone and coordinated disorders mainly in the legs.

In addition, cerebellar ataxia is detected in Creutzfeldt-Jakob disease - a degenerative brain disease that is sporadic (family forms with autosomal dominant inheritance are only 5-15%) and belong to the group of prion diseases (caused by the accumulation of pathological prion protein in the brain brain).

The cause of paroxysmal episodic ataxia may be autosomal dominant hereditary periodic ataxia type 1 and type 2, maple syrup disease, Hartnup disease, and pyruvate dehydrogenase deficiency.

Pathogenesis

The cerebellum, located under the occipital lobes of the cerebral hemispheres behind the medulla oblongata and the pons, is responsible for coordinating movements, regulating muscle tone and maintaining balance.

Normally, afferent information from the spinal cord to the cerebellar cortex of the cerebellum signals muscle tone, body position and extremities that are currently available, and information that comes from the motor centers of the cerebral cortex gives an idea of ​​the desired end state.

The cerebellar cortex compares this information and, calculating the error, transmits the data to the motor centers.

When the cerebellum is damaged, the comparison of afferent and efferent information is disturbed, and therefore there is a lack of coordination of movements (primarily walking and other complex movements that require the coordinated work of muscles - agonists, antagonists, etc.).

Symptoms

Cerebellar ataxia is manifested:

• Violations of standing and walking. While standing, the patient spreads his legs wide and tries to balance the body with his hands. The gait is uncertain, the legs are wide apart when walking, the body is excessively straight, but the patient is “thrown” from side to side anyway (especially the instability is noticeable when turning). With the defeat of the cerebellar hemisphere when walking, there is a deviation from a given direction towards the pathological focus.
• Impaired coordination in the limbs.
• Intentional tremor, which develops when approaching the goal (finger to nose, etc.).
• Chanting speech (no smoothness, it becomes slow and intermittent, stress on each syllable).
• Nystagmus.
• Decreased muscle tone (most often affects the upper limbs). There is increased muscle fatigue, but patients usually have no complaints about a decrease in muscle tone.

In addition to these classic symptoms, signs of cerebellar ataxia include:

• dysmetry (hypo- and hypermetry), which is manifested by excessive or insufficient amplitude of movements;
• dyssynergy, which manifests itself in violation of the coordinated work of various muscles;
• disdiadochokinesis (impaired ability to perform fast alternating opposite in the direction of movements);
• postural tremor (develops when holding a pose).

Against the background of fatigue, the severity of atactic disorders in patients with cerebellar lesions is increasing.

When cerebellar lesions often observed slow thinking and a decrease in attention. The most pronounced cognitive disorders develop when the worm of the cerebellum and its posterior parts are affected.

Cognitive syndromes in the defeat of the cerebellum manifest impaired ability to abstract thinking, planning and fluency, dysprodosy, agrammatism and disorders of visual-spatial functions.

Perhaps the emergence of emotional and personality disorders (irascibility, incontinence of affective reactions).

Diagnostics

Diagnostics is based on data:

• Anamnesis (include information about the time of appearance of the first symptoms, hereditary predisposition, and diseases suffered during life).
• General examination, during which reflexes and muscle tone are assessed, coordination tests are conducted, vision and hearing are checked.
• Laboratory and instrumental studies. They include blood and urine tests, cerebrospinal puncture and analysis of cerebrospinal fluid, EEG, MRI / CT, brain Doppler, ultrasound and DNA studies.

Treatment

Treatment of cerebellar ataxia depends on the nature of the cause of its occurrence.

Cerebellar ataxia of infectious-inflammatory origin requires the use of antiviral or antibacterial therapy.

In case of vascular disorders, angioprotectors, antiplatelet agents, thrombolytics, vasodilators and anticoagulants can be used to normalize blood circulation.

In cerebellar ataxia of toxic genesis, intensive infusion therapy is performed along with the administration of diuretic drugs, and in severe cases hemosorption is used.

In case of hereditary ataxia, the treatment is aimed at the motor and social rehabilitation of patients (physical therapy classes, occupational therapy, speech therapy classes). Assigned to the B vitamins, cerebrolysin, piracetam, ATP, etc.

Amantadine, buspirone, gabapentin or clonazepam may be prescribed to improve muscle coordination, but these drugs have low efficacy.

With the defeat of any part of the cerebellum in the clinic there are always three main cerebellar symptoms: atony, ataxia and asynergia. But the degree of their manifestation depends on the location and size of the lesion.

Atonia or hypotension. Decreased muscle tone is one of the constant symptoms of cerebellar lesions. When the powerful flow of cerebellar impulses to the anterior horns of the spinal cord is stopped, especially if these impulses are interrupted more or less acutely, muscle tone is always reduced. When slowing down and shutting down the function of the cerebellum, the decrease in tone will be insignificant due to the compensation of impaired function due to cortical activity or the remaining parts of the cerebellum. It is therefore natural that with the defeat of both hemispheres of the cerebellum almost no compensation for lost function occurs and hypotension is always roughly expressed regardless of the degree of development of the pathological process. The atony of all muscles is especially intense when the cerebellar worm is affected, since the latter is equally connected with both halves of the body.

It should be emphasized that cerebellar hypotonia evenly spreads to the entire musculature of the body and is expressed to the same extent both in the muscles of the arms and in the muscles of the legs, both in agonists and antagonists. With the defeat of one cerebellar hemisphere, hypotension prevails on the same side.

Ataxia. Dysfunction of the cerebellum is manifested by a group of symptoms, united under the common name - ataxia, which means disorder, lack of coordination of movements.

There are static and kinetic ataxia.

Static ataxia   there is an expression of an imbalance of the body - a violation of the stabilization of the center of gravity. The most grossly imbalance occurs when the cerebellar worm is affected, and to a lesser extent, when the hemispheres are affected. The instability of the body is detected when standing and is expressed in a rough oscillation of the body in all directions. In order not to fall, the patient spreads his legs wide, balances his hands and, swaying from side to side, maintains balance only due to the function of the vestibular apparatus. Gait becomes uncertain ("drunken gait"). With the defeat of one hemisphere of the cerebellum, staggering occurs in the direction of the focus and is especially sharply manifested when the body turns. If ataxia is expressed very harshly, patients are not able not only to stand and walk, but even to sit. The function of stabilizing the center of gravity of the body completely falls out.

Kinetic, or locomotor, ataxia. Dysmetry is the basis of kinetic ataxia. All movements become disproportionate, uncoordinated, and their volume excessive (hypermetry). Accuracy and smoothness of movements are sharply disturbed, especially with thin arm movements. A patient disproportionately widely spreads his fingers when trying to pick up a small object. For example, he pushes a glass and splashes water out of it, and by seizing it in a hand, it can crush it. The patient is not able to smoothly lower the object on the table and puts it jerk. He cannot draw a line of a given size: by inertia of motion, he will certainly continue it further than necessary. For the same reason can not draw a circle. Due to dysmetry, the handwritings change dramatically, the letters are disproportionate, uneven, and all the lines are broken. Ataxia of the musculature is manifested by dysarthria-type speech disorder.

In cerebellar ataxia, the phenomenon of intentional tremor occupies a special place. The accuracy of any movement is possible only under the condition of exact correspondence to the time of the main movement and counter-movement. In other words, for coordinated movement, timely delivery of an additional cerebellar impulse following the pyramidal impulse is necessary in the front horns. When the cerebellar impulse is delayed in transit, the regulating counter-movement is delayed and the main movement is performed in a large volume. Consequently, there is a separation in time of the two phases of the movement - the main and the additional, which normally occur together. The stronger the main movement, the stronger will be the late regulating counter-movement. Under this condition, all movements will occur with constant intermittent recoils: retarded counter-movements all the time will “pull back” the moving body part back. This movement with constant recoils is called intentional tremor. Especially bright intentional tremor appears when trying to hit a certain point with your finger. It can also be observed with eye movement and is known as cerebellar nystagmus (as opposed to vestibular). The emergence of intentional tremor in speech motor skills causes a kind of speech disorder, resembling the chanting of ancient Greek poems. All these three symptoms (intentional tremor, nystagmus and scanned speech) were first described by Charcot with the localization of multiple sclerosis foci in the pons, therefore the whole syndrome is called Charcot's triad.

To identify dynamic ataxia, there are a number of samples (coordination tests), for example, finger-like, index, heel-knee, etc.

Sample deserves special attention by quickly alternating the opposite movements of the hands. Violation of fast alternating movements in the hands is called adiadochokinesis. To identify this symptom, the patient is offered to quickly supin and penetrate the arms of the outstretched arms. With the defeat of the cerebellar hemisphere, the effect of inertia of movement is manifested by the inability to quickly change the direction of movement to the opposite and excessive movement by inertia (hypermetry). Therefore, when trying to quickly rotate the brush, hypersupination and hyperpronation are detected with a slow and awkward transition of one type of movement to another on the side of the same name as the lesion of the cerebellum.

Asynergia. In cerebellar disorders, asynergy is a consequence of the deactivation of the additional cerebellar components in a complex motor act. It is expressed in the impossibility of performing complex movements simultaneously, synergistically (essentially the same phenomena of cerebellar ataxia are observed).

During walking, the torso lags behind the movement of the legs and the patient falls back, as the center of gravity of the body moves too far back. Similar phenomena are observed even if the patient is made to stand back quickly and strongly in a standing position. This reveals the absence of synergistic flexion in the ankle and knee joints, the center of gravity moves backwards and the patient falls. He also fails to simultaneously flex the hip and lower leg when trying to put a knee on the seat of a chair: first, he bends the leg at the hip joint, then at the knee and with a force lowers the knee down.

Asynergia is especially pronounced if a patient lying on his back is asked to sit down without using his hands. Healthy at the same time as bending the trunk fixes the legs and pelvis. With asynergia, this is not possible: instead of the trunk, legs or one leg are raised with a unilateral defeat of the cerebellum.

Additional cerebellar symptoms. In addition to the above-described main symptoms of a cerebellar lesion (atony, ataxia, asynergia), there are additional signs of impaired cerebellar functions.

A complex sense of weight is the result of a combination of evidence from a variety of proprioceptors and tactile sensitivity, which is perceived by the cerebral cortex as a result of a preliminary cerebellar activity. Therefore, patients with lesions of the cerebellum incorrectly assess the weight. On the affected side, the weight will appear to the patient significantly less.

With the defeat of the front legs and the serrated nuclei of the cerebellum, choreic hyperkinesis develops.

The absence or reduction of the counter-movement, regulated by the cerebellum, is detected through a test with a passive extension of the bent forearm. If the doctor suddenly stops the extension, then the patient will not be able to immediately turn on the antagonists and stop the bending, as a result of which he will hit himself in the chest with a hand.

In the absence of cerebellar impulses, limbs become inert, obeying the laws of a moving mass. If the patient passively raise and lower the arm, then it will swing much longer than in the healthy. A similar pendulum-like movement is also observed when receiving a knee-jerk reflex: after a single blow to the quadriceps tendon, the shin makes several damped pendulum-like swings.

Overshot symptom. When examined with open eyes, it is suggested that the researcher’s finger be placed several times with the index finger. Then, the subject must repeat this movement, but with his eyes closed. On the side of the cerebellar focus, the arm misses, often passing outwards from the target, and this is marked with both closed and open eyes.

Pronation symptom. With arms stretched forward in the position of pronation in a patient with eyes closed, the arm on the side of the lesion of the cerebellum is penetrated more strongly.
   The symptom of bradytelekinesia is that in patients with lesions of the cerebellum during the finger-nose test, the movement of the finger near the target seems to slow down, then resume, and the finger reaches the tip of the nose. Interestingly, a kind of slow motion at the goal is detected even in the presence of intentional jitter. This symptom is observed on the side of the lesion in the cerebellum.

Cerebellar imitative phenomenon. In a patient with eyes closed, slightly bend one leg at the knee joint and suggest that he give the other leg the same position. In this case, the patient bends it much more.

   Dizziness   varying degrees observed in all patients with cerebellar disease. Such dizziness is characterized by the absence of hearing impairment.

Related symptoms. The particular topographic position of the cerebellum in the cranial cavity causes, when it is damaged, the occurrence of a number of associated symptoms.

When processes in the cerebellum that alter the brain space in the posterior cranial fossa (tumors, abscesses, cysts, etc.), common brain symptoms appear early as a result of increased intracranial pressure. Increasing headaches, dizziness, vomiting often act as the initial symptoms of the development of the tumor-like process in the cerebellum. Early development of common brain symptoms is explained by the position of the cerebellum in the skull and the possibility of very early development of venous congestion and brain edema.

With the localization of the tumor in the worm of the cerebellum, an acute development of an increase in intracranial pressure may occur. Suddenly there is a severe headache, sometimes with loss of consciousness, impaired respiratory function and cardiac activity (Bruns syndrome). In severe cases, the development of this syndrome can result in death from respiratory paralysis or cardiac activity.

Tumor processes of the cerebellar hemisphere can squeeze the brain stem and cause a number of associated symptoms: lesion of the cranial nerves (usually V, VI and VII), dysfunction of the pyramidal system and sensitive conductors. At the same time, disturbances of the type of alternating syndrome often appear. In some cases, an inverse correlation may be observed as a result of compression by the tumor of the opposite half of the trunk.

Topical diagnosis of lesions of the worm and cerebellar hemispheres. Such diagnostics are very limited and mostly possible only within the limits of the differences in the damage of the worm and the cerebellar hemispheres.

A severe imbalance on the background of diffuse muscle hypotension is characteristic of a worm lesion. A particularly pronounced violation of the stabilization of the center of gravity is caused by the involvement of the rear lobule of the worm, nodulus, and the hemispheric lobe adjacent to it, floculus. In this case, the patient can not only stand, but even sit.

Atonia and ataxia are diffuse. To identify a slight imbalance of the patient put in a position Romberg, and there is a uniform staggering of the body in all directions. With a stronger violation, patients fall back and forth. In contrast to spinal ataxia, the shutdown of vision has almost no effect on the enhancement of cerebellar ataxia.

The lesion of the cerebellar hemispheres is most strongly reflected in the movements of the limbs, that is, dynamic ataxia occurs. Ataxic phenomena and hypotonia are found on the side of the lesion of the cerebellum, in the extremities of the side of the same name, and the patient staggers into the diseased side. With the development of a tumor in the cerebellar cortex, cerebellar symptoms act on the side of the focus. The clinical picture of the tumor of the eighth pair sometimes coincides with that of the cerebellar hemispheres. The correctness of the diagnosis depends on the identification of early, initial symptoms of the disease. When a tumor of the eighth pair is the first to appear from the side of this nerve, and with a tumor of the cerebellar hemisphere - cerebellar symptoms.

In processes in the frontal lobe, ataxia similar to cerebellar phenomena is also sometimes expressed. Balance, standing, and walking are disturbed; coordination less disturbed. These symptoms are sometimes incorrectly regarded as cerebellar, which leads to an erroneous diagnosis. For a correct diagnosis, it is necessary to take into account a number of other associated symptoms characteristic of a lesion of the frontal lobes, as well as the fact that if a frontal lobe is affected, there is ataxia on the side opposite to the lesion.

It can be caused by a variety of consequences. This is explained by the fact that it is associated with almost all parts of the human body, in particular, with the nervous system. As a rule, numerous unpleasant symptoms and problems with this organ are most often called cerebellar ataxia. It manifests itself as a disorder of coordination, an imbalance, etc. At the same time, a person cannot be in the same position for a long time.

Some of the symptoms of a lesion in the cerebellum can be detected with the naked eye. However, more complex hidden signs can only be identified with the help of special laboratory samples. The effectiveness of the treatment of these pathologies depends on the causes of the lesions.

Main functions

The cerebellum performs an enormous amount of work. First of all, it supports and distributes which is necessary for keeping the body in balance. Thanks to the work of this body, a person can perform the motor function. Therefore, speaking of the function and symptoms of the lesion of the cerebellum, the doctor, first of all, checks the coordination of the person. This is because the body helps maintain and distribute muscle tone at the same time. For example, bending the leg of a person simultaneously strains the flexor and relaxes the extensor.

In addition, the cerebellum distributes energy and minimizes the contraction of muscles that are involved in the performance of a particular job. In addition, this body is necessary for motor training. This means that during training or the development of skills, the body remembers which muscle groups contract and tighten.

If the symptoms of the cerebellum are absent, and its functioning is carried out in a normal manner, then the person feels well. If at least one of the parts of this organ suffers from a lesion, then it becomes more difficult for the patient to perform certain functions, or simply he cannot move.

Neurological Pathology

Due to the defeat of this important organ, a huge number of serious illnesses can develop. If we talk about neurology and symptoms of cerebellar lesions, then it is worth noting the most important danger. Damage to this organ leads to impaired blood circulation. The appearance of this pathology can lead to:

• Ischemic stroke and other heart diseases.
• Multiple sclerosis.
• Traumatic brain injury. In this case, the lesion should not always affect the cerebellum, it is enough if at least one of its connections is broken.
• Meningitis.
• type, as well as anomalies caused in the nervous system.
• Intoxication.
• Overdose with certain medications.
• Vitamin B12 deficiency.
• Hydrocephalus obstructive type.

In lesions of the cerebellum are quite common. Therefore, first of all, it is necessary to visit a specialist of this particular area.

The cause of diseases of the cerebellum

In this case, we can talk about injuries, congenital underdevelopment of this area, impaired circulation, the consequences of prolonged drug use. It can also happen due to toxin poisoning.

If a patient is diagnosed with a congenital defect in the development of this organ, then in this case it is a question of a person suffering from a disease called Marie ataxia. This pathology refers to the dynamic ailments.

Symptoms of lesions of the cerebellum and pathways may indicate a stroke, trauma, cancer, infections and other pathologies occurring in the nervous system. People with a fracture of the base of the skull or damage in the occipital region of the head are faced with similar illnesses.

If a person suffers from atherosclerotic vascular lesions, then this can also trigger a violation of the blood supply to the cerebellum. However, this list of all ailments is far from over. A lesion of the carotid artery and vascular spasms that go into hypoxia can also trigger a similar condition.

In addition, it must be borne in mind that most often the symptoms characteristic of lesions of the cerebellum are found in the elderly. This is due to the fact that their blood vessels lose elasticity over time and are affected by atherosclerosis and cholesterol plaques. Because of this, their walls do not withstand strong pressure and begin to burst. Such hemorrhage provokes tissue ischemia.

Signs of pathology

If we talk about the main symptoms of the cerebellum lesion, then ataxia is noted among them, which can manifest itself in different ways. However, most often in a person the head and the whole body begin to tremble even with a calm position of the body. There is weakness of muscles and poor coordination of movements. If one of the cerebral hemispheres is damaged, the movements of the person will be asymmetric.

Also, patients suffer from tremor. In addition, there are strong problems in the process of flexion and extension of the limbs. Many have hypothermia. In the event of symptoms characteristic of a lesion of the cerebellum, the patient may experience a violation of the motor act. In this case, when moving towards a specific goal, a person begins to perform pendulum-reversal actions. In addition, a problem with the cerebellum can cause hyperreflexion, gait disturbance, and severe handwriting changes. It is also worth considering the varieties of ataxia of this organ.

Static Locomotor

In this case, violations of walking person are most pronounced. Any movement brings the strongest load, because of which the body becomes weaker. In this case, it is difficult for a person to be in a position where the heels and toes of the feet are touching. It is difficult to fall forward, backward or sway to the sides. In order to take a stable position, a person needs to spread his legs wide. It is observed very and outwardly the patient, who has symptoms of lesions of the cerebellum, resembles a drunk. When cornering, it can be put to the side, until the fall.

To diagnose this pathology, it is necessary to conduct several tests. First of all, you need to ask the patient to go in a straight line. If he shows the first signs of static-locomotor ataxia, he will not be able to perform this simple procedure. In this case, he will begin to deviate strongly in different directions or too far apart.

Also, to identify the main symptoms of cerebellar lesions, additional tests are carried out at this stage. For example, you can ask the patient to stand up sharply and turn 90 ° to the side. A person who has a damaged cerebellum will not be able to perform this procedure and will fall. With a similar pathology, the patient also cannot move by incremental steps. In this case, he will dance, and the torso will begin to lag a little behind the limbs.

In addition to pronounced problems with gait, there is a strong contraction of the muscles when performing even the most simple movements. Therefore, in order to determine this pathology, you need to ask the patient to get up sharply from a prone position. In this case, his hands should be crossed on his chest. If a person is healthy, his muscles will contract synchronously, he will be able to sit down quickly. With the occurrence of ataxia and the first symptoms of a lesion of the cerebellum, it becomes impossible to simultaneously strain the hips, torso and lower back. Without the help of hands, a person cannot take a sitting position. Most likely the patient will simply fall back.

You can also ask the person to try to bend back while in a standing position. At the same time he must throw back his head. If a person is in a normal state, then in this case he will involuntarily bend the knees and unbend in the hip area. With ataxia, this flexion does not occur. Instead, the person falls.

Dynamic cerebellar ataxia

In this case, we are talking about problems with smoothness and dimensionality of human movements. Ataxia of this type is unilateral or bilateral, depending on which hemispheres occurred violations. If we talk about what symptoms are observed with the defeat of the cerebellum and the manifestation of dynamic ataxia, they are similar to those described above. However, if we are talking about one-sided ataxia, then in this case, problems in moving or performing test tasks in a person will be only in the right or left side of the body.

To identify the dynamic form of pathology, you should pay attention to some features of human behavior. First of all, he will experience severe tremors in the limbs. As a rule, it is enhanced by the moment the movement is completed, which the patient performs. Being in a calm state, a person looks absolutely normal. However, if you ask him to take a pencil from the table, then at first he will stretch his hand without any problems, but as soon as he starts to take the object, his fingers will begin to tremble strongly.

When determining symptoms of lesions of the cerebellum, the diagnosis includes additional tests. With the development of this pathology in patients is observed, the so-called oversight and gimbal. This is due to the fact that human muscles begin to contract disproportionately. Flexors and extensors work much harder. As a result, a person cannot fully perform the simplest actions, for example, put a spoon in his mouth, fasten his shirt or tie a knot on the laces.

In addition, a clear sign of this violation are changes in handwriting. Most often, patients begin to write large and uneven, and the letters become zigzag.

Also, when determining the symptoms of lesions of the cerebellum and pathways, it is worth paying attention to how a person is talking. With the dynamic form of the disease appears a sign, which in medical practice is called chanted speech. In this case, the person speaks as if in jolts. He divides the phrase into several small fragments. In this case, outwardly, the patient looks as if he is broadcasting something to a large number of people from the podium.

Also observed and other phenomena characteristic of this disease. They also concern patient coordination. Therefore, the doctor conducts a series of additional tests. For example, in the “standing” position, the patient must straighten and raise his hand to a horizontal position, take it to the side, close his eyes and try to touch the nose with his finger. Under normal conditions, it is not difficult for a person to perform this procedure. If he has ataxia, he will always miss.

You can also try to ask the patient to close his eyes and touch the tips of two index fingers to each other. If there are problems in the cerebellum, then the patient will not be able to match the limbs as necessary.

Diagnostics

Considering the symptoms of the cerebellar lesion and the methods of investigation, it is worth paying attention to the fact that for any irregularities in the brain, you should immediately contact a neurologist. He conducts a series of tests in order to clarify how superficial and deep reflexes work for a person.

If we talk about hardware research, it may be necessary to perform electron histagmography and vestibulometry. Required to pass a complete blood count. If a specialist suspects an infection in the cerebrospinal fluid, then a lumbar puncture is performed. Need to check markers for stroke or inflammation. Additionally, you may need an MRI of the brain.

Treatment

The success of therapy depends on the causes of this pathology. Therefore, speaking of the symptoms and treatment of lesions of the cerebellum, it is worth considering the most common cases.

If the disease is accompanied by ischemic stroke, the lysis of blood clots is required. Also, a specialist prescribes fibrinolytics. To prevent the emergence of new blood clots are prescribed antiplatelet agents. These include "Aspirin" and "Clopidogrel." Additionally, you may need to take metabolic drugs. These include "Mexidol", "Cytoflavin" and others. These funds help to improve metabolic processes in the brain tissue.

In addition, to prevent re-stroke, you must undergo a course of drugs that reduce the amount of cholesterol in the blood.

If, in studying the symptoms and causes of cerebellar damage, the doctor determines that the patient suffers from neuroinfections (for example, encephalitis or meningitis), then treatment with antibiotics is required.

Problems caused by intoxication of the body can be solved with the help of detoxification therapy. However, it is necessary to clarify the type and characteristics of the poison. In difficult situations, it is necessary to take immediate measures, so the doctor conducts forced diuresis. When food poisoning enough to wash the stomach and take sorbents.

If a patient is diagnosed with cancer, then everything depends on its stage and type of pathology. As a rule, radiation and chemotherapy are prescribed for treatment. In some situations, surgery may be required.

Also, experts prescribe drugs that can improve blood flow (for example, Caviton), vitamin complexes, anticonvulsants, and medications that strengthen muscle tone.

A beneficial effect has therapeutic exercise and massage sessions. Thanks to a special set of exercises, it is possible to restore muscle tone. This helps the patient to return to normal. Also carried out physiotherapy activities (medical baths, electrical stimulation, etc.).

Also, considering the symptoms, causes and treatment of lesions of the cerebellum, it is worth paying attention to several brain pathologies encountered in medical practice.

Betten's disease

This pathology belongs to the category of hereditary diseases. She meets not so often. In this case, a person has all the signs of cerebellar ataxia, which are recorded in babies in the first 12 months of life. There are serious problems in coordination, the child cannot focus his eyes, there is hypotonia.

Some children begin to hold their heads only by 2-3 years, and later they begin to talk and walk. However, in most cases, even after a few years, the baby's body adapts to the pathology, and the signs of cerebellar damage are no longer apparent.

Cerebellar Holmes Degeneration

When progressing most damaged jagged nuclei. In addition to the standard signs of ataxia, patients have epileptic seizures. However, this pathology usually does not affect the intellectual abilities of a person. There is a theory that this pathology is hereditary, but accurate scientific evidence of this fact does not exist today.

Alcoholic cerebellar degeneration

A similar pathology appears on the background of chronic alcohol intoxication. In this case, the cerebellar worm is affected. First of all, when diagnosing an ailment in patients, problems with limb coordination are observed. Sight and speech are disturbed. Patients suffer from severe memory impairment and other problems of brain activity.

Based on this, it becomes obvious that problems with the cerebellum appear against the background of other pathologies. Although neurological problems most often lead to ataxia, this is not the only factor that affects a person’s health. Therefore, it is important to pay attention to the symptoms, consult a qualified specialist and make a diagnosis. Simple samples can be performed at home. However, after that, you need to consult a doctor, identify the main cause of the occurrence of an unpleasant disease and begin immediate treatment with drugs and physiotherapy.