Cerebellar diseases cause incoordination, clumsiness and tremors because the cerebellum is responsible for smoothing out and refining voluntary movements. The cerebellum is the region of the brain responsible for controlling stance, gait and balance, as well as the coordination of complex and goal-directed movements.
The acute onset of cerebellar symptoms is considered a medical emergency and requires immediate medical attention. When the cerebellum is damaged, the nerve signals become disjointed and fail to flow smoothly, making usual, daily tasks difficult.
Common signs and symptoms of cerebellar disorders
- A vision condition in which the eyes make repetitive, uncontrolled movements.
- These movements typically result in reduced vision and depth perception, often affecting balance and coordination.
- These involuntary eye movements can occur from side to side, up and down or in a circular pattern.
- Resting tremor of the head (rotatory, rocking or bobbing movement).
- Staccato speech
- Patients may have explosive, monosyllabic speech.
- Skew deviation of the eyes
- Vertical misalignment of the eyes.
- One points up and the other points down, resulting in diplopia of vertical gaze.
- The head ends up being tilted toward the side of the lower eye.
- Ocular dysmetria
- A constant under- or over-shooting of the eyes when attempting to focus the gaze on something.
- In some cases of cerebellar disorders, patients may have head deviation and or inaccurate finger–nose or finger–finger coordination.
- Coarse, rapid, side-to-side oscillations on the affected side.
- When outstretched, the arm will drift aimlessly.
- When the arm’s position is changed with a sharp tap, the arm position may overcorrect and won’t be able to achieve its original position.
- The patient will be unable to perform rapid alternating movements, such as repeated pronation-supination.
- Truncal ataxia
- The patient will not be able to sit up straight with their eyes closed and may even fall over.
- A person will be unable to sit on the bed without steadying themselves.
- Gait disturbance
- The classical sign of a cerebellar disorder is a wide-based stance at rest.
- The person will also walk with their legs far apart to balance themselves.
- Tandem gait
- The cerebellar patient may not be able to walk heel-to-toe without losing balance.
- In some cases, patients may not be able to smoothly run their heel along their shin (performed under heel-shin test).
- The cerebellar patient may stagger like a drunk person to the side of the lesion.
The main clinical features of cerebellar disorders include incoordination, imbalance, tremors and troubles with eye movements.
What are the two distinguishable cerebellar syndromes?
There are two distinguishable cerebellar syndromes:
- Midline cerebellar syndromes
- These syndromes are characterized by an imbalance
- Patients are unsteady and are unable to stand and maintain balance with their eyes open or closed
- Severe midline disturbance causes truncal ataxia (dyscoordination)
- Some persons have bobbing motions of the head or trunk (titubation)
- Also often affect eye movements, and there may be nystagmus, ocular dysmetria and poor pursuit
- Hemispheric cerebellar syndromes
- They are characterized by incoordination of the limbs.
- There may be the decomposition of movement, dysmetria and rebound.
- Dysdiadochokinesis (the irregular performance with rapid alternating movements) is often seen in this syndrome.
- Tremors may be present when attempting to touch an object (intention tremors).
- A kinetic tremor may be present (tremor prominent when the digit is in motion).
- The finger-to-nose and heel-to-knee tests are classic tests of hemispheric cerebellar dysfunction.
- While reflexes may be depressed initially with hemispheric cerebellar syndromes, this cannot be counted on.
- Speech may be dysarthric, scanning or have an irregular emphasis on syllables.
There is no single specific treatment for cerebellar disorders. Instead, treatment is used to improve or relieve specific symptoms, and the goal is to improve the quality of life for the patients. Treatment often includes both pharmacological and nonpharmacological interventions. Early intervention with physical and occupational therapy, as well as neuropsychology for associated learning disorders, are required to ensure that patients with cerebellar disorders reach their potential.
What is cerebellar degeneration?
Cerebellar degeneration is a process in which neurons (nerve cells) in the cerebellum (the area of the brain that controls coordination and balance) deteriorate and die. Causes of the syndromes may be classified as either:
- (Friedreich’s ataxia, cerebellar cortical atrophy, multisystem atrophy and olivopontocerebellar degeneration)
Diseases that cause cerebellar degeneration can also involve other areas of the central nervous system, including the spinal cord, cerebral cortex and brainstem. Cerebellar degeneration may be the result of changes that alter the normal production of specific proteins that are necessary for the survival of neurons.
The signs and symptoms of cerebellar degeneration are:
- Wide-based, unsteady, lurching walk, which is often accompanied by a back-and-forth tremor in the trunk of the body
- Slow, unsteady and jerky movement of the arms or legs
- Slowed or slurred speech
There is no cure for hereditary forms of cerebellar degeneration. Treatment is usually supportive and is based on the person's symptoms. For example, drugs may be prescribed to ease gait abnormalities, while physical therapy can strengthen muscles. Other disorders that may contribute to cerebellar degeneration can use treatment to ease symptoms.
- The Predicted 'Tripledemic' Is Here: Why Isn't There an RSV Vaccine?
- Frozen Stuffed Chicken Products & Microwave Ovens: A Recipe for Salmonella
- First FDA-Approved Fecal-Based Treatment Helps Fight a Tough Superbug
- Seizures Seem Tied to Faster Decline in People With Dementia
- Signs That COVID Infection Might Harm the Liver
- More Health News »
Health Solutions From Our Sponsors
Schmahmann JD. Disorders of the Cerebellum: Ataxia, Dysmetria of Thought, and the Cerebellar Cognitive Affective Syndrome. J Neuropsychiatry Clin Neurosci. 2004 Summer;16(3):367-78. https://web.math.princeton.edu/~sswang/CB-pediatric/REVIEW-schmahmann_CB-dysmetria-of-thought.pdf
Arnold D. The Cerebellum. University of Calgary. https://cumming.ucalgary.ca/sites/default/files/teams/122/cerebellar-disorders.pdf
Top What Are Cerebellar Symptoms Related Articles
Brain and Spinal Cord Tumors in Adults (Symptoms, Signs, Causes, Treatment Options, Life Expectancy)Brain and spinal tumor are diseases in which cancer (malignant) cells begin to grow in the tissues of the brain. Tumors that start in the brain are called primary brain tumors. Tumors that start in the brain and spread to other organs are called primary brain tumors. Symptoms may include headaches, personality changes, dizziness, and trouble walking. Treatment depends upon the type and grade of tumor.
ConcussionA concussion is a short-lived loss of brain function that is due to head trauma. There are two types of concussion, simple and complex. Symptoms of a concussion include headache, nausea, dizziness, dazed feeling, irritability, and visual symptoms. Physical signs include poor concentration, emotional changes, slurred speech, and personality changes. Concussion is diagnosed with physical examination and testing. Treatment for a concussion in general includes treatment for control of the symptoms and time.
Brain Damage: Symptoms, Causes, TreatmentBrain damage causes destruction or deterioration of brain cells. Traumatic brain injury (TBI) and acquired brain injury (ABI) are two kinds of brain damage. Symptoms may include headaches, confusion, memory problems, nausea, and more. Treatment includes patient stabilization and ensuring that blood and oxygen are flowing to the brain. Adequate blood pressure control is also necessary. In cases of severe brain damage, surgery and rehabilitation may be required.
Brain and Nervous System: Conditions That Can Cause HallucinationsWhat medical conditions are known to cause auditory or visual hallucinations?
Brain PictureThe brain is one of the largest and most complex organs in the human body. See a picture of the Brain and learn more about the health topic.
10 Facts About the Amazing Brain QuizTake this brain quiz to learn about your amazing brain! It's the most complex part of your body, and is responsible for many functions, including how you behave!
Brain Tumor: Warning Symptoms, Types, Causes, Treatments, and CureA brain tumor can be either non-cancerous (benign) or cancerous (malignant), primary, or secondary. Common symptoms of a primary brain tumor are headaches, seizures, memory problems, personality changes, and nausea and vomiting. Causes and risk factors include age, gender, family history, and exposure to chemicals. Treatment is depends upon the tumor type, grade, and location.
Can You Heal a Damaged Brain?Brain damage can be caused either by a traumatic brain injury (TBI) or acquired brain injury (ABI). You cannot heal a damaged brain. Medical treatments can just help to stop further damage and limit the functional loss from the damage.
Concussions & Brain Damage QuizWhat is a concussion? Learn causes, symptoms, and treatments of this very common traumatic brain injury by taking this quick quiz.
Deep Brain StimulationDeep brain stimulation (or DBS) is a way to inactivate parts of the brain that cause Parkinson's disease and its associated symptoms without purposefully destroying the brain. In deep brain stimulation, electrodes are placed in the thalamus (to treat essential tremor and multiple sclerosis) or in the globus pallidus (for Parkinson's disease).
Head Injury (Brain Injury)In the United States, head injuries are one of the most common causes of death and disability. Head injuries due to bleeding are generally classified by the location of the blood within the skull, these include epidural hematoma, subdural hematoma, subarachnoid bleed, intracranial bleed, sheer injury, edema, and skull fracture. Some common symptoms of a head injury include vomiting, bleeding from the ear, speech difficulties, paralysis, difficulty swallowing, and body numbness. Treatment of a head injury depends on the type and severity of the injury.
How Conditions Change Your BrainThe brain doesn’t always stay the same. Mental disorders, health issues, and lifestyle habits can alter the way it looks and works.
How the Brain Works: Test Your Medical IQTake this quiz and test your knowledge of how the human brain works. You may be surprised!
Left Brain vs. Right Brain (Characteristics, Differences, and Functions)
Are left brain vs. right brain theories myth or fact? They actually are a little of both! Scientists and researchers have tried to answer this question since the 1800s. In the 1960s, neuroscientist Roger Sperry began to research the right brain vs. left brain theory. In 1981, together with neuroscientist Torsten Wiesel, he won the won the Nobel Prize for his "split-brain" theory. In the split-brain theory, the left and right sides of the brain are connected by the corpus callosum (where place each side of the brain meets and sends signals and communicates with other), and that both the left and right sides of the brain have specific functions.
What is an example of right-brain vs. left brain theory? Scientists now know that for most people who are right-handed, the language center of their brain is located in the Broca are of the left side of the brain. Moreover, research suggests that that emotions and creativity are located in the right-side of the brain. The medical field calls this "brain lateralization." While researchers and scientists don't fully understand the functions of the right-and -left sides of the brain or hemispheres, but through ongoing research there are endless possibilities in learning how the brain functions.
REFERENCE: Corballis, MC. "Left Brain, Right Brain: Facts and Fantasies." PLoS Biol. 2014 Jan; 12(1): e1001767.
Brain Foods for Kids: Healthy Food for Kids’ BrainsUse this brain foods list to make your child smarter and healthier with these brain-boosting meals! Developing brains needs the right foods to boost learning and improve concentration.
Types of Traumatic Brain Injury (TBI) MedicationsTraumatic brain injury and related conditions, may require diuretics, anticonvulsants, sedatives, antidepressants, muscle relaxers, pain relievers, and stimulants to treat deficits in cognitive functions such as attention, memory, learning and language.
Weird Body Quirks: From Brain Freeze to HiccuppingIce cream brain freeze, hiccups, charley horses, vertigo--what's behind these weird body quirks anyway? Our experts explain several odd body behaviors.
What Is the Main Function of the Cerebellum?The cerebellum (popularly known as the little brain) is located behind and at its bottom of the brain where the spinal cord meets the brain. It is made of two halves known as the cerebellar hemispheres.