Cerebellar ataxia

Cerebellar ataxia is a form of ataxia originating in the cerebellum.

Overview

Cerebellar ataxia can occur as a result of many diseases and presents with symptoms of an inability to coordinate balance, gait, extremity and eye movements. Lesions to the cerebellum can cause dyssynergia, dysmetria, dysdiadochokinesia, dysarthria and ataxia of stance and gait. Deficits are observed with movements on the same side of the body as the lesion (ipsilateral). Clinicians often use visual observation of people performing motor tasks in order to look for signs of ataxia.

Causes

There are many causes of cerebellar ataxia including, among others, autoimmunity to Purkinje cells or other neural cells in the cerebellum, CNS vasculitis, multiple sclerosis, infection, bleeding, infarction, tumors, direct injury, toxins (e.g., alcohol), and genetic disorders.

Associated morbidity

Damage to the cerebellum, particularly to the cerebrocerebellum area and the cerebellar vermis, is almost always associated with clinical depression and often with alcoholism. Due to difficulties in mobility, self-care, everyday activities, and pain/discomfort, those with cerebellar ataxia are more likely to be diagnosed with anxiety and depression. Almost a third of patients with isolated, late onset cerebellar ataxia go on to develop multiple system atrophy.

Ataxia

Ataxia (from Greek α- [a negative prefix] + -τάξις [order] = "lack of order") is a neurological sign consisting of lack of voluntary coordination of muscle movements that includes gait abnormality. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum. Ataxia can be limited to one side of the body, which is referred to as hemiataxia. Several possible causes exist for these patterns of neurological dysfunction. Dystaxia is a mild degree of ataxia. Friedrich's ataxia has gait abnormality as the most commonly presented symptom.

Types

Cerebellar

The term cerebellar ataxia is used to indicate ataxia that is due to dysfunction of the cerebellum. The cerebellum is responsible for integrating a significant amount of neural information that is used to coordinate smoothly ongoing movements and to participate in motor planning. Although ataxia is not present with all cerebellar lesions, many conditions affecting the cerebellum do produce ataxia. People with cerebellar ataxia may have trouble regulating the force, range, direction, velocity and rhythm of muscle contractions. This results in a characteristic type of irregular, uncoordinated movement that can manifest itself in many possible ways, such as asthenia, asynergy, delayed reaction time, and dyschronometria. Individuals with cerebellar ataxia could also display instability of gait, difficulty with eye movements, dysarthria, dysphagia, hypotonia, dysmetria and dysdiadochokinesia. These deficits can vary depending on which cerebellar structures have been damaged, and whether the lesion is bilateral or unilateral.

Stanford University School of Medicine

Stanford University School of Medicine is the medical school of Stanford University and is located in Stanford, California. It is the successor to the Medical Department of the University of the Pacific, founded in San Francisco in 1858 and later named Cooper Medical College; the medical school was acquired by Stanford in 1908. Due to this descent, it ranks as the oldest medical school in the Western United States. The medical school moved to the Stanford campus near Palo Alto, California in 1959.

The School of Medicine, along with Stanford Health Care and Lucile Packard Children's Hospital, is part of Stanford Medicine. It is a research-intensive institution that emphasizes medical innovation, novel methods, discoveries, and interventions in its integrated curriculum.

History

In 1855, Illinois physician Elias Samuel Cooper moved to San Francisco in the wake of the California Gold Rush. In cooperation with the University of the Pacific (also known as California Wesleyan College), Cooper established the Medical Department of the University of the Pacific, the first medical school on the West Coast, in 1858, on Mission Street near 3rd Street in San Francisco. The school underwent many changes until Cooper's nephew, Levi Cooper Lane, established a new campus at the intersection of Webster and Sacramento Streets in 1882; at that time, the school was christened Cooper Medical College. Lane also built a hospital and a nursing school (forerunner of the Stanford School of Nursing) and made provision for the creation of Lane Medical Library.