May 30, 2024

Cerebellar examination is a part of a complete neurological examination concerned with the evaluation of all the functions of the cerebellum.

Cerebellar examination
Cerebellum

Classification of cerebellum

1. Archicerebellum: Concerned with truncal movement, balance, posture

2. Paleocerebellum: Concerned mainly with tone

3. Neocerebellar(major portion): Concerned with crude movements

The nucleus of the cerebellum

DEFG

  • Dentate
  • Embolism
  • Fastigii
  • Globus

Functions of the cerebellum and cerebellar examinations

SIDDHART N DP

Pneumonics
SIDDHARTNDP
Scanning
Speech
Intention
Tremor
DysdiadokinesiaDysmetriaHypotoniaAtaxic
Gait
Rebound
Phenomena
Truncal
Ataxia
NystagmusDyssynergiaPendular
Jerk

Nystagmus

The involuntary rhythmic movement of the eye

Types of NystagmusAffected lesion in Anatomical features
HorizontalVestibular nucleus, Cerebellum
RotatoryLabyrinthCircular (@)
Verticalthe brain stemStraight (¥)
Nystagmus according to anatomical sites

Examination: Check for nystagmus in the eye

Scanning Speech

Examinations:

Prerequisites:- There should be no weakness in the limbs

Ask to speak : PA_TA_KA

Hot potato speech will be heard i.e. there will be long pauses between syllables and words with a loss of melody in speech production

Tremor

Intentional tremor (Target approach tremor) is seen

A tremor is a coarse rapid side-to-side oscillation that increases as the person approaches the target.

Examinations:

Ask the patient to approach a target with the tip of the finger

Tremor will be seen and unable to approach the target

Rest tremor is present during rest. Eg. Parkinsonism

Dysdiadokinesia

Inability to defined as the inability to perform rapid alternating muscle movements

Examination:

Ask the patient to do quick, synchronous, and can include pronation/supination, fast finger tapping, opening and closing of the fists, and foot tapping

Unable to do so

Dysmetria

Dysmetria is the inability to control the distance, speed, and range of motion necessary to perform smoothly coordinated movements and activities.

Examination:

Pre-pointing

Could not approach the target by pointing the finger

Rebound Phenomena

 Rebound phenomena is elicited by having the patient attempt to move a limb against resistance. When the resistance is suddenly removed, the limb normally moves a short distance in the desired direction and then rebounds (jerks back in the opposite direction)

Examination:

Pre-requisites: Eye close

Unable to control hand movement, the hand will hit the face

Dyssynergia

Dyssynergia is any disturbance of muscular coordination, resulting in uncoordinated and abrupt movements.

Examination:

Ask the patient to perform step-by-step work

Unable to perform in a sequence suggest dyssynergia

Step-by-step work

Truncal Ataxia (Head nodding)

Examination:

Ask patient to squat and stand up

 Involuntary tremor that occurs in the head, neck, and trunk area or called Titubation

Pendular Jerk

Examination:

Pre-requisites: Sitting position knee jerk in performed

(>3 times) signifies increase jerk

Hypotonia

Look for the tone of muscle

See also: Motor Examination

Gait

Wide-based Ataxic gait (gait while drunk)

Details on Gait