cerebellar ataxia
Introduction
Introduction The posture of the human body is maintained and freely performed, and has a close relationship with the brain, the basal ganglia, the vestibular system, and the deep sensation. Damage to these systems will lead to poor coordination of movement, balance disorders, etc. These signs and symptoms are called ataxia. According to different lesions, ataxia can be divided into four types: 1 deep sensory ataxia; 2 cerebellar ataxia; 3 vestibular labyrinthine ataxia; 4 brain type ataxia. The "acingle imbalance" commonly referred to in the clinic is more specifically referred to as cerebellar ataxia.
Cause
Cause
Cerebellar ataxia is caused by the cerebellum and its associated neurological pathology.
Torso ataxia
Torso ataxia (posterior cerebellar ataxia), mainly manifested in the patient's gait and posture (standing and sitting) balance obstacles, such as unstable standing, unstable sitting, unstable walking, Romberg sign (Eyes, eyes closed) positive (unstable), upper limb ataxia is unclear, obvious, nystagmus often does not. The location diagnosis is mainly damaged in the cerebellar vermis (primary cerebellum). Can be seen in ADCA type III, ataxia telangiectasia and the like.
Limb coordination ataxia
Coordinated ataxia of the extremities (motor cerebellar ataxia), mainly manifested by the balance of obstacles in the patient's limbs, such as finger-nose test, inaccurate knee-shoulder test, poor distance, poor rotation, Misunderstanding of the test biased to the disease side, nystagmus is more common (thickness), gait instability. Generally, the upper limbs have a greater degree of ataxia than the lower limbs. The location diagnosis is mainly damaged in the cerebellar hemisphere (new cerebellum).
Whole cerebellar ataxia
All cerebellar ataxia, lesions in the original cerebellum, new cerebellum, cerebellar nuclei, cerebellar pass (exit) fibers, clinical manifestations of trunk, limb, gait ataxia, can be seen in ADCAI type.
other
In addition, some types of IAS have obvious peripheral nerve damage, spinal cord posterior cord damage, and manifested as deep sensory ataxia. It is characterized by the fact that when there is no visual aid, the symptoms of ataxia are more obvious. When walking, the head is often looked down at the road under the foot. It is difficult to face the front and the road is more difficult at night. When washing the face, the body is easy to dump in the direction of the basin. Romberg is more obvious when collecting eyes. Unstable, often accompanied by deep feelings (positional sense, vibration) reduced or lost. Can be seen in Friedreich ataxia, Refsum syndrome, posterior column ataxia, Roussy-Levy ataxia.
Examine
an examination
Related inspection
Brain Doppler Ultrasound (TCD)
Cerebellar ataxia is the most common symptom of (hereditional ataxia), and almost 100% of patients with IAs have ataxia. Cerebellar ataxia can be observed through the daily activities of IAs patients, such as dressing, buttoning, water, writing, eating, speech, gait, etc. Unstable walking, gait squatting, inflexible movements, and wide legs when walking; adult patients cannot walk straight when walking. Suddenly left and right, the curve progresses, showing the pace of the scissors, showing a "Z" shape forward deflection, and trying to use the upper limbs to help maintain the stability of the body. The change in muscle tone can be changed to a sputum state as the lesion can be reduced, and the ataxia gait can also be transformed into a sacral ataxia gait. Standing unsteady, leaning forward or shaking sideways. When standing on the toes or standing on the heels, the shaking is more stable and the fall is often the patient's early complaint. Patients often say: "When walking a path or an uneven road, walking is more stable and more likely to fall." As the disease progresses, the patient may behave in an unstable or inability to stay in bed.
Diagnosis
Differential diagnosis
Differential diagnosis of cerebellar ataxia:
1 Torso ataxia (posterior cerebellar ataxia): mainly manifested in the patient's gait and posture (standing and sitting) balance obstacles, such as unstable standing, unstable sitting, unstable walking, Romberg sign ( Blinking, closed eyes) positive (unstable), upper limb ataxia is unclear, obvious, nystagmus often does not. The location diagnosis is mainly damaged in the cerebellar vermis (primary cerebellum). Can be seen in ADCA type III, ataxia telangiectasia and the like.
2 Four-limb coordination ataxia (motor cerebellar ataxia): mainly manifested as the balance of obstacles in the limbs of the patient, such as finger-nose test, knee-shoulder test is not allowed, poor distance, poor rotation Misunderstanding, the test is biased toward the diseased side, the nystagmus is more common (thickness), and the gait is unstable. Generally, the upper limbs have a greater degree of ataxia than the lower limbs. The location diagnosis is mainly damaged in the cerebellar hemisphere (new cerebellum);
3 full cerebellar ataxia: the lesions in the original cerebellum, new cerebellum, cerebellar nuclei, cerebellar pass (out) fibers, clinical manifestations of torso, limbs, gait ataxia. Can be seen in the ADCAI type and so on.
