METHODICAL INSTRUCTIONS
FOR INDIVIDUAL WORK OF THE STUDENTS
IN PREPARATION FOR PRACTICAL CLASSES
Subject
NEUROLOGY
Topic
Cerebellum. Cerebellum lesion syndromes
Year
IV
Faculty
Medical
1. Topicality: cerebellum is a part of the extrapyramidal system and at the same time it
plays a role of the centre of a reflex movement coordination, equilibrium and muscular
tonus. Numerous connections of the cerebellum with different sections of nervous
systems preconditions frequent attack of coordination system by various pathological
processes (encephalitis, demyelinating diseases of nervous system, craniocerebral
injuries, brain tumors etc.) Correct methodological approach to learning basic rules of
coordination function gives an opportunity to define the localization of a pathological
process, to state topical and clinical diagnosis, to administer necessary well-timed
treatment.
2. Specific purposes:
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To interpret principles of cerebellum structure and functions
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To interpret realization of movement coordination
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To diagnose, differentiate and classify various types of ataxias
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To be able to evaluate symptoms of cerebellum lesion
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To evaluate main clinical attributes of cerebellum lesions
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To be able to define the level of coordination system lesion
3. Basic knowledge, skills, competences necessary for learning the topic:
№ п/п
Subject
Information to learn
Anatomy
To describe cerebellum location, its anatomic
structures. To know phylo- and ontogenesis of the
cerebellum.
To find principles of functioning of a coordination
system. To evaluate movement coordination.
To describe histological structure of the
cerebellum
1
2
Physiology
3
Histology
Assignments for individual work during preparation for the classes
а) The list of basic terms, characteristics, which students must learn during the preparation
for the classes:
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Vermis, cerebellar hemispheres
Purkinje’s ganglious cells
Dentate, vesicular, cortical nuclei and fastigial nucleus
Cerebellar peduncles
Staticolocomotory and dynamic ataxia
Intention tremor
Dysmetria, adiadochocinesis
Scanning speech
Nystagmus
Asynergism, reverse push symptom
Romberg’s test, dactylic and genucalcaneal tests
б) The list of theoretical questions:
1. Anatomy and physiology of cerebellum
2. Apherent and epherent conductive tracts of cerebellum
3. Regulation of equilibrium, movement coordination and muscular tonus
4. Pathology of movements synergy
5. Staticolocomotory and dynamic ataxia
6. Intention tremor
7. Pathophysiology of asynergetic symptoms
8. Peculiarities of the muscular tonus change in the cerebellum lesion
9. Main clinical symptoms of cerebellar hemispheres lesion
10. Main clinical symptoms of vermis lesion
11. Abnormalities of speech and writing in cerebellum lesion
в) The list of practical skills that are to be mastered at the classes:
1. To evaluate gait and define the presence of ataxia
2. Methodic of Romberg’s position evaluation
3. Methodic of conducting dactylic and genucalcaneal tests
4. Methodic of conducting tests on diadochokinesis, correspondence of movements
(dysmetria)
5. Methodic of conducting and evaluation of the Stewart-Holmes test
6. Methodic of nystagmus evaluation
7. To define the condition of speech and the type of its abnormality (scanning speech)
8. Methodic of muscular tonus evaluation
9. To be able to distinguish between different types of ataxias.
4. Students’ self-preparation curriculum:
1. To learn theoretical questions of the topic 5 (see the list of the theoretical questions and
information sources).
2. To know the methodic of examination of coordination system
3. To see the tests and situational tasks and to find correct answers (the collection of tests
and tasks, the “Cerebellum” chapter)
5. Materials for self-control:
1. To draw the scheme of apherent and epherent cerebellum tracts; to draw a table with a
picture of main symptoms of staticolocomotory and dynamic ataxia (“tottering gait”,
intention tremor, Romberg’s posture deviation, adiadochocinesis)
2.
to tests and situational tasks (the collection of tests and tasks – module 1, topical module
1, the «Cerebellum” chapter)
Information Sources: Lecture
1. Shcrobot S.I., Hara I.I. Neurology in lecture (Selected lectures) . Ternopil, TSMU,
«Ukrmedknyha», 2008. 319 p.
2. Reinhard Rohkamm. Color Atlas of Neurology © 2004 Thieme. 440 p.
3. Crash course Neurology by Anish Bahra and Katia Cikurel. Copyright 2006, Elsevier,
Inc. 244 p.
4. Adams and Victors. Principles of neurology. © 2005 McGraw-Hill . Medical Publishing
Division.
5. Mayo Clinic Internal Medicine Review 2006-2007. Chapter 18. Editor-in-Chief Thomas
M. Habermann, MD