Disturbance of speech
Scanning dysarthria may occur with speech occasionally delivered with sudden unexpected force - explosive speech. Whether dysarthria results from hemisphere or midline vermis disease remains debatable.
Dysarthria, like nystagmus, is an inconsistent finding in cerebellar disease.
Titubation is a rhythmic 'nodding' tremor of the head from side to side or to and fro, usually associated with distal limb tremor. It appears to be of little localising value.
Abnormal head tilt suggests a lesion of the anterior vermis. Note that a IV (trochlear) cranial nerve palsy and tonsillar herniation also produce this abnormal posture.
Myoclonic jerks and choreiform involuntary movements occur with extensive cerebellar disease involving the deep nuclei.
ASSOCIATED NON-CEREBELLAR SIGNS AND SYMPTOMS: These arise from:
(Extensor spasms from brain stem damage may be wrongly described as 'cerebellar fits'.)
- obstructive hydrocephalus
- cranial nerve involvement
- brain stem involvement.
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