5 ATAXIC

Question 1

Ataxia: Site of Lesion

Answer 1

• Cerebellum or cerebellar nuclei pathway

Question 2

The cerebellum is involved in ___ learning and it may have a ___ component

Answer 2

motor, cognitive

Question 3

Ataxia results in the reduction in control of: (5)

Answer 3

Reduction in control of
• Rate
• Range
• Force of motor act
• Coordination
• Integration of sensory and motor information

Question 4

There are more neurons in the ___ than cortex

Answer 4

cerebellum

Question 5

Ataxia: Characteristics (15)

Answer 5

• Nystagmus
• Inaccuracy
• Disturbed righting reflex
• Equilibrium deficit
• Gait disturbance
• Coordination problems
• Overshoot
• Slow initiation
• Irregular DDK
• Dysrhythmia
• Hypotonic
• Clumsy
• Intention tremor with increase at termination of movement
• Tremor at rest (essential tremor)
• Random errors in target contact

Question 6

A key indicator for ataxia is ___.

Answer 6

DDK - diadochokinesis

Question 7

Define: Dysmetria

Answer 7

Cerebellar disorder resulting in poor eye-hand coordination, overshooting movements

Question 8

___ can be mistaken for __ __.

Answer 8

Discoordination, essential tremors

Question 9

[T/F] Intention tremor - The amplitude of an intention tremor increases as an extremity approaches the endpoint of deliberate and visually guided movement.

Answer 9

True

Question 10

Essential tremor is __ times more prevalent in Parkison’s.

Answer 10

8

Question 11

Ataxic Disarthria: Degenerative Diseases (3)

Answer 11

• Friedereich’s ataxia
• Olivopontocerebellar atrophy (OPCA)
• Multiple Sclerosis

Question 12

Friederich’s Ataxia (4)

Answer 12

• Inherited, Autosomal recessive
• Begins pre-adolescent
• 15 year course to wheelchair
• Death around 35 years due to cardiac issues

Question 13

Friederich’s Ataxia: Characteristics (5)

Answer 13

• Ataxia
• Sensory disturbance
• Spasticity
• LMN weakness
• Extrapyramidal features including dystonia, chorea

Question 14

Define: Dystonia

Answer 14

A neurological movement disorder syndrome in which sustained or repetitive muscle contractions result in twisting and repetitive movements or abnormal fixed postures

Question 15

Define: Chorea

Answer 15

a neurological disorder characterized by jerky involuntary movements affecting especially the shoulders, hips, and face

Question 16

Define: Extrapyramidal Tract (4)

Answer 16

• Neural network, part of motor system
• Originates in brain stem, carries motor fibres to spinal cord
• Responsible for involuntary and automatic control of musculature, including muscle tone, balance, posture, and locomotion
• Four tracts: Vestibulospinal, reticulospinal, rubrospinal, tectospinal

Question 17

Olivoponteocerebellar Atrophy (OPCA): Etiology

Answer 17

Autosomal dominant

Type of multiple systems atrophy disease

Degeneration of pontine nuclei

Arcuate fasciculus of cortex (temporal to frontal)
olivary nuclei (MSO and LSO)
Middle cerebellar peduncles

Cerebellum

Sometimes also basal ganglia, cerebral cortex, spinal cord, peripheral nerves

Question 18

Olivoponteocerebellar Atrophy (OPCA): Characteristics (2)

Answer 18

• Progressive ataxia of gait

* Progressive ataxic dysarthria

Question 19

Multiple Sclerosis is usually accompanied by __ dysarthria.

Answer 19

mixed

Question 20

Paroxysmal ataxic dysarthria (PAD):

Answer 20

associated with MS
• Brief episodes of ataxic dysarthria

• Accompanied by limb or visual problems
• 5-30 seconds each

Question 21

Vascular Disorders that may result in Ataxic Dysarthria (3)

Answer 21

• Hemorrhage
• Arteriovenous malformations resulting in hemorrhage
• Ischemic Infarct

Question 22

Define: Thrombosis

Answer 22

Blood clot preventing flow of blood through circulatory system

Question 23

Define: Ischemic Infarct

Answer 23

Stroke caused by lack of oxygen due to blood clot or obstruction

Question 24

Define: Arteriovenous Malformation (AVM)

Answer 24

Abnormal connection btw arteries and veins

Question 25

Common locations for an Ischemic Infarct: (3)

Answer 25

* Posterior inferior cerebellar artery at level of medulla * Anterior inferior cerebellar artery at level of pons * Superior cerebellar artery at level of midbrain

Question 26

Define: Neoplasm

Answer 26

a new and abnormal growth of tissue, can become cancerous

Question 27

Characteristics of Cerebellopontine angle tumors (4)

Answer 27

* Meningiomas usually * Results in pressure on middle cerebral peduncle, dentate nucleus, posterior cerebellar lobes * Often includes cranial involvement of V, VI, VIII, VIII, X * May be ataxic, flaccid, spastic

Question 28

Neoplasms can involve cranial nerves _, _, _, _, and _.

Answer 28

``` V - Trigeminal VI - Abducens VII - Facial VIII - Vestibulocochlear X - Vagus ```

Question 29

Neoplasms that can result in Ataxic Dysarthria: (3)

Answer 29

* Cerebellopontine angle tumors * Tumors in fourth ventricle * Astrocytomas of cerebellar hemispheres

Question 30

Define: Astrocytomas

Answer 30

Cancer of the brain and spinal cord originating in glial cells (astrocytes).

Question 31

Astrocytoma: Characteristics (3)

Answer 31

* Relatively common in children * 25% of metastatic brain tumors arise in cerebellum * Paraneoplastic disorders: secondary to cancer in other regions, destroy purkinje cells

Question 32

Define: Purkinje Cells (3)

Answer 32

* AKA Purkinje Neurons * Located in the Cortex Responsible for all output of all motor coordination in the cortex.

Question 33

Trauma can result in __ __ and __.

Answer 33

limb apraxia, dysarthria

Question 34

Ataxic Dysarthria: Trauma-related Causes (3)

Answer 34

* TBI * Injury to the Superior cerebellar peduncles * Dementia pugilistica

Question 35

The superior cerebellar peduncles are vulnerable to __ __.

Answer 35

rotational injuries

Question 36

Dementia pugilistica = __ __.

Answer 36

boxer injury

Question 37

Ataxic Dysarthria: Toxic/Metabolic-related Causes (3)

Answer 37

* Acute and chronic alcohol abuse * Anti-convulsants * Lithium