Pathology
In diseases of the cerebellum are manifested three groups of symptoms: 1) depending on the tissue damage to the cerebellum; 2) by engaging in the process formations, located near M. within the posterior cerebral fossa (stem syndrome and disorders of the cranial nerves); 3) involvement in the process supratentorial located departments of the Central nervous system. With the defeat of neotorularia departments develop cerebellar symptoms, and with the defeat of the so-called vestibular divisions - approaches vestibular. Progression of local lesions (tumors) approaches vestibular symptoms are the result of the defeat of cerebellar tissue only in the initial stages of the disease; they largely arise from the involvement of the Central vestibular formations, located in stem the brain.
To cerebellar symptoms include cerebellar hypotension, impaired coordination of movements of the limbs, cerebellar thread (asthenia, weakness), hyperkinesia (tremor and mioclauniei), speech disorders cerebellar origin; it approaches the vestibular violations of statics and walking, Sinergia Babinsky.
Cerebellar hypotension. The severity of muscle hypotonia increases, accordingly, to increase damage to the cerebellum and possibly with involvement in the process and timing of the kernel. Observed sometimes in the defeat M toning and its difficult improper distribution largely associated with involvement in the process of stem lesions.
Infringement of coordination of movements of the limbs. The term cerebellar ataxia (in respect of specialized movements of the limbs) unites a number of symptoms that evidence of the violation of the regulation of motor acts, their coordination. These symptoms include violations of the scope of the motor act (dysmetria, hypermetria, geometry), errors directions of its violation of the pace (slow). Infringement of coordination of movements is one of the components of the hemispheric cerebellar syndrome. However, it is more clearly revealed in the upper extremities, which is connected with the particular development of human subtle specialized asymmetric movements of the upper limbs.
Cerebellar paresis (asthenia, weakness). With the defeat of the cerebellum in acute and chronic forms of the disease decreased strength is observed Homo-lateral defeat and is a consequence of the violation of the tone.
Giperkineza. When the lesions M. meet the following types of hyperkinesia: 1) atoxicity, or dynamic, tremor, appearing with the active movements in the limbs; it includes the so-called intentsionnogo tremor, increased to achieve the objective; 2) mioclonii - fast twitching of individual groups of muscles or muscle observed in humans in the limbs, neck and swallowing muscles. Koreizsky-acetone movement in limbs in cerebellar lesions are rare; they are tied with the involvement of systems dentate nucleus. Also rarely occur twitching muscles of the neck and mioclonii soft palate and pharynx walls. Mioclonii occur when the involvement of the stem lesions.
Speech disorders diseases of M are observed in three forms: cerebellar bradylalia and staccato speech, bulbar, mixed. When bulbar violations expressed even in mild, it is difficult to decide whether, in this case, besides them, speech disorders and cerebellar origin. Only in rare cases with mild phenomena defeat IX and X pairs of cranial nerves on severity of staccato speech can be assumed her cerebellar origin. When staccato speech accents are placed not in the sense, and separated uniform intervals.
Violations of statics and walking, occurring in patients with the disease of the cerebellum, can be a consequence of the defeat approaches vestibular formations, located in the convent, and the vestibular formations, located in stem the brain. This statokinetic disorder may be of different intensity from the subtle staggering walk when standing, walking (with a slight breeding feet) up sharply pronounced forms trunk ataxia, but when a patient able to stand or sit without support falls back or to the side. To severe disorders of gait are staggering gait legs wide apart, zigzag evasion or tax avoidance in certain side from the set direction; this often creates the impression of a drunken gait".
Sinergia (or dyssynergia)- the impossibility of simultaneous joint, or synergistic, perform complex movements. If a healthy person to lay on his back with his arms folded and offer him get into a sitting position, he will do it easily, because simultaneously with the bending of the body are fixed legs and pelvis to prop plane. Patient with Sinergia this cannot carry out because of lack of synergy muscle groups, bending the body and fixing the pelvis and lower limbs, instead of a body he raised both legs, or one leg on the affected side.
