Clinical Features, Assessment, and Management of Patients with Developmental and Other Cerebellar Disorders

Abstract

The cerebellum is essential for processing, modulating, and controlling movement, behavior, and cognitive functions. Cerebellar disorders cause tremor and incoordination, larger variability, and inaccuracy of movements during eye and limb movements, stance, and speech. Cerebellar dysfunction also results in impaired cognition and behavior. During the clinical assessment, details of the presenting complaints including onset and time course of ataxia, other symptoms, past medical history including developmental milestones, family history, and drug history are elicited. On examination emphasis is placed on examining the motor system especially speech and eye and limb movements. Other aspects include general examination, head size, dysmorphic features, neurocutaneous stigmata, and cognitive function assessment. A thorough exam of the cranial nerves, tone, strength, coordination, reflexes, gait, and sensation should be undertaken. A comprehensive assessment helps to narrow down the diagnostic possibilities and offers clues to specific disorders of the cerebellum. Management is guided by disease etiology.