Ataxia. Cerebellum treatment with folk remedies Traditional medicine in the treatment of atrophic changes in the brain

is the feeling of movement of oneself, or
things around. Very often people, coming to see a doctor,
complain of dizziness. Dizziness can be caused by various
diseases, both benign and very life-threatening.
Approximately 80 causes have been identified that can cause dizziness, of which 20%
combine a number of reasons.

In a healthy person, the state of equilibrium occurs due to
combination of signals from vestibular, visual and proprioceptive
systems that enter the human cerebral cortex. The impulses that
originate from the cerebral cortex, reach the skeletal and eye muscles, thanks to
This ensures a stable posture and the desired position of the eyeballs.

If the receipt of impulses from the vestibular departments
into the cortex of the temporal and parietal lobes is disturbed, illusory perception occurs
the movement of surrounding things or your body. Again, patients, often the concept
"dizziness" is misunderstood. Sometimes a person, experiencing a state of nausea,
approaching loss of consciousness, feelings of emptiness, "lightness in the head" perceive
like dizziness. Although these symptoms of impending fainting are associated with
vegetative disorders such as; pale skin, palpitations,
nausea, blurred vision, hyperhidrosis
(sweating). A similar condition can be caused by cardiovascular pathology, orotostatic
hypotension, hypoglycemia, anemia, high myopia.

Often, patients under dizziness take a violation
balance, i.e. unsteadiness, staggering when walking. Such disorders can
be after an organic lesion of the nervous system, and by itself is not
dizziness.

Types of dizziness

Psychogenic dizziness: appears
after strong emotional experiences, or because of severe fatigue.
At the same time, a person feels a vague feeling of instability, ambiguity in the head,
weakness. Pathological conditions that are accompanied by dizziness,
some mental syndromes can become - hysteria, depersonalization, anxiety
with panic attacks.

Dizziness in brain disorders usually
occurs due to pathologies of the cerebellum. It can be;
tumor, displacement of the cerebellum with hydrocephalus, trauma to the skull or cervical region
spine, vascular disorders of the brain. Severe dizziness can
signal a cerebellar infarction; it comes from
for hemorrhages in the cerebellum, if the patient
is conscious. The defeat of the vegetative nuclei, which are located under
cerebral hemispheres, are the second important cause of cerebral
dizziness. This may be due to inflammatory or vascular
lesions, or in case of poisoning with chemicals or medicinal
drugs. These drugs include barbiturates and
anticonvulsants that cause drowsiness and lethargy,
dizziness. Excessive intake of streptomycin leads to irreversible brain damage.

Vertigo of the eye occur in healthy
people due to unusual visual stimulation (for example,
fast movement of objects or at height). Pathology may also be the cause.
eye muscles, that is, paralysis, which leads to a violation of the projection of objects
on the retina and "drawing up" the wrong picture in the brain.

Dizziness with ear pathology possibly due to damage to various structures:
vestibular apparatus; nerves and blood vessels; or Eustachian tube (connecting
ear cavity with nasal cavity). Dizziness associated with hearing loss, pain or tinnitus, or
the same manifestation of dizziness at a certain position of the head, can
occur depending on location
lesions. The simplest cause
dizziness can become a sulfur plug in the external auditory canal.

Ataxia is a violation of coordination of movements, balance. Static ataxia - imbalance in the usual standing position, dynamic - coordination disorders when moving. The word ataxia itself is of Greek origin: in translation it means "mess". Another name for pathology is incoordination.

Ataxia is quite common, it is manifested by inaccuracy of movements, imbalance, a person goes astray from the consistent rhythm of performing any actions. Since the human body has a number of parts of the nervous system that are responsible for the balance and coordination of the body, then in case of any deviations, it makes sense to suspect violations of the normal functioning of one of them - the cerebellum, the vestibular apparatus, the conductors of deep joint-muscular sensitivity, the cortex of the frontal lobe, sometimes the temporal and occipital lobes of the brain.

Symptoms

Difficulties in coordinating the movements of the arms, legs and body in general.
Loss of balance while standing or moving.
Fear of falling.
Involuntary trembling of the muscles of the limbs.
Dizziness, nausea, vomiting.
Deceleration of speech, impaired facial expressions.
Handwriting changes.
Mental disorders.

Types of ataxia

Sensitive - disorders of the functioning of conductors of deep joint-muscular sensitivity.
Cerebellar - a violation of the normal functioning of the cerebellum.
Vestibular - violations of the vestibular apparatus or its individual parts.
Cortical - damage to the cortex of the frontal lobe, sometimes the temporal and occipital lobes of the brain.

Sensitive ataxia develops with the destruction of the posterior columns of the spinal cord, damage to peripheral nerves, sometimes the cortex of the parietal lobe of the brain. Usually observed in funicular myelosis, vascular disorders, polyneuropathy, tumors. A person's legs give way, the gait changes, movement is possible only under enhanced visual control, i.e. the patient constantly looks down at his feet. Walking alone is extremely difficult.

Cerebellar ataxia is the result of damage to the hemispheres, vermis and cerebellar peduncles. Being in the Romberg position (in a standing position, with tightly shifted feet, eyes closed and arms extended forward), the patient literally collapses and falls towards the damaged cerebellar hemisphere. If the cerebellar vermis is affected, then the patient can fall not only from side to side, but also forward, backward, movements are slow. Flank gait (walking sideways to the right or left) is extremely wrong. There is also a speech disorder - slowing down, lengthening. The handwriting changes sharply and becomes poorly legible. Cerebellar ataxia is often just a symptom of another serious disease - encephalitis, brain tumor, multiple sclerosis.

Vestibular ataxia - observed in the disorder of the normal functioning of the vestibular apparatus. Signs: dizziness, which increases with the rotation of the head, nausea, vomiting, involuntary eye movement. Main causes: encephalitis, ear disease, brain tumor, Meniere's disease.

Cortical ataxia - caused by damage to the cortex of the frontal lobe, less often the temporal and occipital lobes of the brain. Signs: difficulty walking, staggering from side to side, mental disorders, olfactory disorders. Main causes: tumor, brain abscess, cerebrovascular accident.

Hereditary ataxia of Pierre Marie - is transmitted from parents to children, while rarely children manage to avoid such transmission. All signs of cerebellar ataxia are observed, as well as cerebellar hypoplasia, atrophy of the brain bridge. The disease manifests itself in adulthood (after 30-35 years), manifested by difficulties in walking, speech disorders, facial expressions, inability to make quick hand movements. Other signs: involuntary movements of the muscles of the limb and fingers, ptosis, Argyle Robertson's symptom, scotoma, depression, fear.

Friedreich's family ataxia is hereditary, especially if there is a blood marriage between the parents. The main symptom is gait disturbance: a person spreads his legs wide when walking. Over time, coordination disorders are transmitted to the hands, and then to the face: facial muscles twitch, speech slows down, hearing deteriorates, reflexes decrease. The consequences are very severe: disruption of the heart, an increase in the risk of bone fractures, dislocations of the joints, curvature of posture. Often the disease is accompanied by diabetes mellitus, hormonal disorders, dysfunctions in the genital area.

Ataxia-telangiectasia (another name for Louis-Bar syndrome) - also inherited, first manifests itself in early childhood - at the age of 9-10 years, the child can no longer walk independently. Signs: mental retardation, thymus hypoplasia, increased susceptibility to acute infectious diseases (pneumonia, bronchitis, inflammation of the paranasal sinuses, otitis media). The child's immune system is very weak, unable to resist viruses and infections. Often there is a malignant tumor. The prognosis for the treatment of the disease is unfavorable.

Diagnostics

The following diagnostic methods are used:

Electroencephalography of the brain.
MRI of the brain.
Electromyography.
Carrying out DNA diagnostics.
Additionally - a laboratory blood test, an examination by an ophthalmologist, a neuropathologist, a psychiatrist.

Treatment

Self-treatment of ataxia is impossible, be sure to contact a neurologist. A neurologist will find out the main symptoms, as well as the causes of the disease. Treatment, as a rule, is aimed at symptoms and includes the use of B vitamins, cerebrolysin, ATP, immunoglobulins, riboflavin, therapeutic exercises, etc. An individual approach is developed for each patient. With hereditary forms of the disease, treatment is very difficult, often the symptoms accompany the patient for many years.

Prevention

It is not possible to carry out prophylaxis specifically for ataxia. First of all, it is necessary to carry out the prevention of acute infectious diseases (pneumonia, otitis media, sinusitis, etc.), which can provoke the disease in question. Blood marriages should be avoided. You also need to remember that hereditary ataxia is almost certainly passed on to the child, so often patients are advised to abandon the birth of their own children and adopt another child.

1. How does the "normal" cerebellum work? 2. What is cerebellar ataxia? 3. Symptoms of cerebellar disorders 4. Atactic gait 5. Intentional tremor 6. Nystagmus 7. Adiadochokinesis 8. Mismatch or hypermetry 9. Scanned speech 10. Diffuse muscle hypotension 11. Causes of the disease 12. Hereditary forms 13. About treatment

Coordination of movements is a natural and necessary quality of any living creature that has mobility, or the ability to arbitrarily change its position in space. This function must be performed by special nerve cells.

In the case of worms that move on a plane, it is not necessary to allocate a special organ for this. But already in primitive amphibians and fish, a separate structure appears, which is called the cerebellum. In mammals, this organ, due to the variety of movements, is being improved, but it has received the greatest development in birds, since the bird perfectly owns all degrees of freedom.

A person has a specific movement, which is associated with the use of hands as tools. As a result, coordination of movements turned out to be unthinkable without mastering the fine motor skills of the hands and fingers. In addition, the only way to move a person is upright walking. Therefore, the coordination of the position of the human body in space is unthinkable without constant balance.

It is these functions that distinguish the human cerebellum from a seemingly similar organ in other higher primates, and in a child it must still mature and learn proper regulation. But, like any individual organ or structure, the cerebellum can be affected by various diseases. As a result, the functions described above are violated, and a condition called cerebellar ataxia develops.

How does a "normal" cerebellum work?

Before approaching the description of diseases of the cerebellum, it is necessary to briefly talk about how the cerebellum is arranged and how it functions.

The cerebellum is located at the bottom of the brain, under the occipital lobes of the cerebral hemispheres..

It consists of a small middle section, a worm, and hemispheres. The worm is an ancient department, and its function is to provide balance and statics, and the hemispheres developed along with the cerebral cortex, and provide complex motor acts, for example, the process of typing this article on a computer keyboard.

The cerebellum is closely connected with all the tendons and muscles of the body. They contain special receptors that “tell” the cerebellum what state the muscles are in. This feeling is called proprioception. For example, each of us knows, without looking, in what position and where his leg or hand is, even in the dark and at rest. This sensation reaches the cerebellum via the spinocerebellar tracts ascending in the spinal cord.

In addition, the cerebellum is connected to the system of semicircular canals, or the vestibular apparatus, as well as to the conductors of the articular-muscular sense.

It is this path that works brilliantly when, having slipped, a person “dances” on ice. Without having time to figure out what is happening, and without having time to be frightened, a person restores balance. This triggered a "relay" that switched information from the vestibular apparatus about changes in body position immediately, through the cerebellar vermis to the basal ganglia, and then to the muscles. Since this happened "on the machine", without the participation of the cerebral cortex, the process of restoring balance occurs unconsciously.

The cerebellum is closely connected to the cerebral cortex, regulating the conscious movements of the limbs. This regulation takes place in the cerebellar hemispheres

What is cerebellar ataxia?

Translated from Greek, taxis is movement, taxis. And the prefix "a" means negation. Broadly speaking, ataxia is a disorder of voluntary movements. But after all, this violation can occur, for example, with a stroke. Therefore, an adjective is added to the definition. As a result, the term "cerebellar ataxia" refers to a set of symptoms that indicate a lack of coordination of movements, the cause of which is a violation of the function of the cerebellum.

It is important to know that in addition to ataxia, the cerebellar syndrome is accompanied by asynergy, that is, a violation of the friendliness of the movements performed relative to each other.

Some believe that cerebellar ataxia is a disease that affects adults and children. In fact, this is not a disease, but a syndrome that can have various causes, and occur with tumors, injuries, multiple sclerosis and other diseases. How does this lesion of the cerebellum manifest itself? This disorder manifests itself in the form of static ataxia and dynamic ataxia. What it is?

Static ataxia is a violation of coordination of movements at rest, and dynamic ataxia is a violation of them in movement.. But doctors, when examining a patient who suffers from cerebellar ataxia, do not distinguish such forms. Much more important are the symptoms that indicate the location of the lesion.

Symptoms of cerebellar disorders

The function of this organ is as follows:

maintaining muscle tone with the help of reflexes;

maintaining balance;

coordination of movements;

their coherence, that is, synergy.

Therefore, all the symptoms of damage to the cerebellum to one degree or another are a disorder of the above functions. We list and explain the most important of them.

Atactic gait

This symptom appears during movement, and is almost not observed at rest. Its meaning lies in the appearance and amplification of the amplitude of oscillations of the distal limbs upon reaching the goal. If you ask a sick person to touch his own nose with his index finger, then the closer the finger is to the nose, the more he will begin to tremble and describe various circles. Intention is possible not only in the arms, but also in the legs. This is revealed during the heel-knee test, when the patient is offered to hit the knee of the other, extended leg with the heel of one leg.

Nystagmus is an intentional tremor that occurs in the muscles of the eyeballs. If the patient is asked to look away, then there is a uniform, rhythmic twitching of the eyeballs. Nystagmus is horizontal, less often - vertical or rotatory (rotational).

This phenomenon can be verified as follows. Ask the seated patient to place their hands on their knees, palms up. Then you need to quickly turn them over with your palms down, and up again. The result should be a series of "shaking off" movements, synchronous in both hands. With a positive test, the patient goes astray, and synchrony is broken.

Missing, or hypermetry

This symptom manifests itself if the patient is asked to quickly hit with his index finger an object (for example, a neurologist's hammer), the position of which is constantly changing. The second option is to hit a static, motionless target, but first with your eyes open and then with your eyes closed.

Symptoms of speech disorders are nothing more than an intentional tremor of the vocal apparatus. As a result, speech acquires an explosive, explosive character, loses its softness and smoothness.

Diffuse muscle hypotension

Since the cerebellum regulates muscle tone, the cause of its diffuse decrease may be signs of ataxia. In this case, the muscles become flabby, sluggish. The joints become "wobbly" because the muscles do not limit the range of motion, habitual and chronic subluxations may appear.

In addition to these symptoms, which are easy to check, cerebellar disorders can be manifested by changes in handwriting, and other signs.

It should be said that the cerebellum is not always to blame for the development of ataxia, and the doctor's task is to figure out at what level the lesion occurred. Here are the most characteristic causes of the development of both the cerebellar form and ataxia outside the cerebellum:

Damage to the posterior funiculus of the spinal cord. This causes a sensitive ataxia. Sensitive ataxia is so named because the patient has impaired joint and muscle sensation in the legs and is unable to walk normally in the dark until he can see his own legs. This condition is characteristic of funicular myelosis, which develops in a disease associated with a lack of vitamin B12.
Extracerebellar ataxia can develop with diseases of the labyrinth. Thus, vestibular disorders and Meniere's disease can cause dizziness, falling, although the cerebellum is not involved in the pathological process;

Appearance of neuroma of the vestibulocochlear nerve. This benign tumor may present with unilateral cerebellar symptoms.

Actually cerebellar causes of ataxia in adults and children can occur with brain injuries, vascular diseases, and also due to a tumor of the cerebellum. But these isolated lesions are rare. More often, ataxia is accompanied by other symptoms, such as hemiparesis, dysfunction of the pelvic organs. This is what happens with multiple sclerosis. If the demyelination process is successfully treated, then the symptoms of cerebellar damage regress.

hereditary forms

However, there is a whole group of hereditary diseases in which the motor coordination system is predominantly affected. Such diseases include:

Friedreich's spinal ataxia;
hereditary cerebellar ataxia of Pierre Marie.

Cerebellar ataxia of Pierre Marie was previously considered a single disease, but now several variants of the course are distinguished in it. What are the signs of this disease? This ataxia begins late, at the age of 3 or 4, and not at all in a child, as many people think. Despite the late onset, the symptoms of cerebellar ataxia are accompanied by a speech disorder like dysarthria, an increase in tendon reflexes. Symptoms are accompanied by spasticity of skeletal muscles.

Usually, the disease begins with a gait disorder, and then nystagmus begins, coordination in the hands is disturbed, deep reflexes are revived, and an increase in muscle tone develops. Poor prognosis occurs with atrophy of the optic nerves.

This disease is characterized by a decrease in memory, intelligence, as well as impaired control of emotions and volitional sphere. The course is steadily progressive, the prognosis is poor.

Treatment of cerebellar ataxia, as a secondary syndrome, almost always depends on success in the treatment of the underlying disease. In the event that the disease progresses, for example, as hereditary ataxia, then in the later stages of the development of the disease, the prognosis is unfavorable.

If, for example, due to a brain contusion in the back of the head, pronounced disturbances in coordination of movements occur, then the treatment of cerebellar ataxia can be successful if there is no hemorrhage in the cerebellum and there is no cell necrosis.

A very important component of treatment is vestibular gymnastics, which must be performed regularly. The cerebellum, like other tissues, is able to "learn" and restore new associative connections. This means that it is necessary to train coordination of movements not only with damage to the cerebellum, but also with strokes, diseases of the inner ear, and other lesions.

Folk remedies for cerebellar ataxia do not exist, since traditional medicine had no idea about the cerebellum. The maximum that can be found here is a remedy for dizziness, nausea and vomiting, that is, purely symptomatic remedies.

Therefore, if you have problems with gait, tremors, fine motor skills, then you should not postpone a visit to a neurologist: the disease is easier to prevent than to treat.

Cerebellar atrophy - This is a pronounced, rapidly progressive pathology that develops when metabolic processes fail, often associated with structural anatomical abnormalities.

Causes of cerebellar atrophy

The cerebellum itself is an anatomical formation (older than even the midbrain), consisting of two hemispheres, in the connecting groove between which is the cerebellar vermis.

The causes of cerebellar atrophy are very different and include a fairly extensive list of diseases that can affect the cerebellum and its associated connections. Based on this, it is quite difficult to classify the causes that led to this disease, but it is worth highlighting at least some:

Sequelae of meningitis.
Cerebral cysts located in the area of the posterior cranial fossa.
Tumors of the same localization.
Hyperthermia. Sufficiently prolonged thermal stress for the body (heat stroke, high temperature).
result of atherosclerosis.
Consequences of a stroke.
Almost all pathological manifestations associated with processes occurring in the posterior cranial region.
Metabolic disorders.
With intrauterine damage to the cerebral hemispheres. The same reason can be an impetus for the development of cerebellar atrophy in a child in infancy.
Alcohol.
Reaction to certain drugs.

Symptoms of cerebellar atrophy

The symptomatology of this disease, as well as its causes, is quite extensive and is directly related to the diseases or pathology that caused it.

The most common symptoms of cerebellar atrophy are:

Vertigo.
Sharp headaches.
Nausea turning into vomiting.
Drowsiness.
Hearing impairment.
Slight or significant violations of the process of walking, (unsteadiness in walking).
Hyporeflexia.
Increased intracranial pressure.
Ataxia. Disorder of coordination of voluntary movements. This symptom is observed both temporarily and permanently.
Ophthalmoplegia. Paralysis of one or more cranial nerves that innervate the muscles of the eye. May appear temporarily.
Areflexia. Pathology of one or more reflexes, which is associated with a violation of the integrity of the reflex arc of the nervous system.
Enuresis is urinary incontinence.
Dysarthria. Disorder of articulate speech (difficulty or distortion of spoken words).
Tremor. Involuntary rhythmic movements of individual parts or the whole body.
Nystagmus. Involuntary rhythmic oscillatory eye movements.

Atrophy of the cerebellar vermis

The cerebellar worm is responsible in the human body for the balance of the center of gravity of the body. For healthy functioning, the cerebellar vermis receives an information signal that goes along the spinocerebellar pathways from various parts of the body, vestibular nuclei and other parts of the human body, which are complexly involved in the correction and maintenance of the motor apparatus in spatial coordinates. That is, just atrophy of the cerebellar vermis leads to the fact that normal physiological and neurological connections collapse, the patient has problems with balance and stability, both when walking and at rest. By controlling the tone of the reciprocal muscle groups (mainly the muscles of the trunk and neck), the cerebellar vermis weakens its functions during its atrophy, which leads to movement disorders, constant tremor and other unpleasant symptoms.

A healthy person tenses the muscles of the legs when standing. With the threat of a fall, for example, to the left side, the left leg moves in the direction of the intended direction of the fall. At the same time, the right leg comes off the surface as if in a jump. With atrophy of the cerebellar vermis, the connection in the coordination of these actions is disrupted, which leads to instability and the patient may fall even from a small push.

Diffuse atrophy of the brain and cerebellum

The brain with all its structural components is the same organ of the human body as everything else. Over time, a person ages, and his brain ages along with him. Violated and, to a greater or lesser extent, brain activity, its functionality atrophies: the ability to plan and control their actions. This often leads an elderly person to a distorted idea of the norms of behavior. The main cause of atrophy of the cerebellum and the entire brain is the genetic component, and external factors are only a provocative and aggravating category. The difference in clinical manifestations is associated only with the predominant lesion of one or another part of the brain. The main general manifestation of the course of the disease is that the destructive process gradually progresses, up to the complete loss of personal qualities.

Diffuse atrophy of the brain and cerebellum can progress due to numerous pathological processes of various etiologies. At the initial stage of development, diffuse atrophy, in its symptoms, is quite similar to late cortical atrophy of the cerebellum, but over time, other symptoms more specific to this particular pathology join the basic symptoms.

The impetus for the development of diffuse atrophy of the brain and cerebellum can be both a traumatic brain injury and a chronic form of alcoholism.

For the first time, this impairment of brain function was described in 1956, based on monitoring behavior, and after death, directly on the study of the very brain of American soldiers, who had been subjected to post-traumatic vegetative pressure for quite a long time.

To date, physicians differentiate three types of brain cell death.

Genetic type is a natural, genetically programmed, process of death of neurons. A person ages, the brain gradually dies.
Necrosis - the death of brain cells occurs due to external factors: bruises, craniocerebral injuries, hemorrhages, ischemic manifestations.
cell suicide. Under the influence of certain factors, the cell nucleus is destroyed. Such a pathology can be congenital or acquired under the influence of a combination of factors.

The so-called "cerebellar gait" in many ways resembles the movement of a drunk. Due to impaired coordination of movement, people with atrophy of the cerebellum, and the brain as a whole, move uncertainly, they sway from side to side. This instability is especially manifested when it is necessary to make a turn. If diffuse atrophy has already passed into a more severe, acute stage, the patient loses the ability not only to walk, stand, but also sit.

Atrophy of the cerebellar cortex

In the medical literature, another form of this pathology is quite clearly described - late atrophy of the cerebellar cortex. The primary source of the brain cell-destroying process is the death of Purkinje cells. Clinical studies show that in this case there is demyelination of the fibers (selective damage to the myelin layers located in the amniotic zone of the endings of both the peripheral and central nervous systems) of the dentate nuclei of the cells that make up the cerebellum. The granular layer of cells usually suffers little. It undergoes a change in the case of an already acute, severe stage of the disease.

Cell degeneration begins from the upper zone of the worm, gradually expanding to the entire surface of the worm and further to the cerebral hemispheres. The last zones that undergo pathological changes, with the neglect of the disease and the acute form of its manifestation, are olives. During this period, the processes of retrograde (reverse) rebirth begin to flow in them.

An unequivocal etiology of such damage has not been identified to date. Doctors suggest, based on their observations, that the cause of atrophy of the cerebellar cortex can be various kinds of intoxication, the development of cancerous tumors, as well as progressive paralysis.

But, as sad as it sounds, in most cases it is not possible to determine the etiology of the process. It is only possible to state changes in certain areas of the cerebellar cortex.

An essential characteristic of atrophy of the cerebellar cortex is that, as a rule, it begins in patients already at an age, and is characterized by a slow course of pathology. Visual signs of the course of the disease begin to appear in the instability of gait, problems when standing without support and support. Gradually, the pathology captures the motor functions of the hands. It becomes difficult for the patient to write, use cutlery, and so on. Pathological disorders, as a rule, develop symmetrically. A tremor of the head, limbs and the entire body appears, the speech apparatus begins to suffer, and muscle tone decreases.

Complications and consequences

The consequences of cerebellar atrophy are devastating for a sick person, since in the process of the rapid development of the disease, irreversible pathological processes occur. If the patient's body is not supported at the initial stage of the disease, the end result can be a complete degradation of a person as a person - this is socially and a complete inability to adequately act - physiologically.

From a certain stage of the disease, the process of cerebellar atrophy cannot be reversed, but it is possible to freeze the symptoms, as it were, preventing them from progressing further.

A patient with cerebellar atrophy begins to feel uncomfortable:

There is uncertainty in movements, the syndrome of "drunk" gait.
It is difficult for the patient to walk, stand without support or support from loved ones.
Problems with speech begin: slurred language, incorrect construction of phrases, inability to intelligibly express one's thoughts.
Gradually, manifestations of the degradation of social behavior are progressing.
The tremor of the limbs, head and entire body of the patient begins to be visualized. It becomes difficult for him to do seemingly elementary things.

Diagnosis of cerebellar atrophy

To establish the correct diagnosis, a patient with the above symptoms must consult a neurologist, and only he is able to unambiguously make a diagnosis.

Diagnosis of cerebellar atrophy includes:

A neuroimaging method that involves a visual examination by a doctor of a patient, checking his nerve endings for a reaction to external stimuli.
Revealing the patient's history.
Genetic predisposition to this category of diseases. That is, whether there were cases of relatives with similar diseases in the patient's family.
Assistance in the diagnosis of cerebellar atrophy is provided by computed tomography.
A neurologist may refer a newborn for an ultrasound examination.
MRI is quite high and with a high probability reveals this pathology of the cerebellum and brain stem, and shows other changes that fall into the study area.

Cerebellar ataxia is a syndrome that occurs when a special structure of the brain called the cerebellum, or its connections with other parts of the nervous system, is damaged. Cerebellar ataxia is very common and can be the result of a wide variety of disorders. Its main manifestations are a disorder of coordination of movements, their smoothness and proportionality, imbalance and maintenance of body posture. Some signs of the presence of cerebellar ataxia are visible to the naked eye even to a person without a medical education, while others are detected using special tests. Treatment of cerebellar ataxia largely depends on the cause of its occurrence, on the disease of which it is a consequence. About what can cause the occurrence of cerebellar ataxia, what symptoms it manifests itself and how to deal with it, you will learn by reading this article.

The cerebellum is a part of the brain located in the posterior cranial fossa below and behind the main part of the brain. The cerebellum consists of two hemispheres and the vermis, the middle part that unites the hemispheres with each other. The average weight of the cerebellum is 135 g, and the size is 9-10 cm × 3-4 cm × 5-6 cm, but despite such small parameters, its functions are very important. None of us think about what muscles need to be strained in order, for example, to simply sit down or stand up, take a spoon in hand. It seems to happen automatically, you just have to want it. However, in fact, to perform such simple motor acts, the coordinated and simultaneous work of many muscles is required, which is feasible only with the active functioning of the cerebellum.

The main functions of the cerebellum are:

maintaining and redistributing muscle tone to keep the body in balance;
coordination of movements in the form of their accuracy, smoothness and proportionality;
maintaining and redistributing muscle tone in synergistic muscles (performing the same movement) and antagonist muscles (performing multidirectional movements). For example, to bend the leg, it is necessary to simultaneously tighten the flexors and relax the extensors;
economical expenditure of energy in the form of minimal muscle contractions necessary to perform a particular type of work;
participation in the processes of motor learning (for example, the formation of professional skills associated with the contraction of certain muscles).

If the cerebellum is healthy, then all these functions are carried out imperceptibly for us, without requiring any thought processes. If some part of the cerebellum or its connections with other structures is affected, then the performance of these functions becomes difficult, and sometimes simply impossible. That's when the so-called cerebellar ataxia occurs.

The spectrum of neurological pathology that occurs with signs of cerebellar ataxia is very diverse. Causes of cerebellar ataxia can be:

disorders of cerebral circulation in the vertebrobasilar basin (and, dyscirculatory encephalopathy);
and bridge-cerebellar angle;
with damage to the cerebellum and its connections;
, meningoencephalitis;
degenerative diseases and anomalies of the nervous system with damage to the cerebellum and its connections (, and others);
intoxications and metabolic disorders (for example, alcohol and drug use, lead intoxication, diabetes mellitus, and so on);
overdose of anticonvulsants;
vitamin B12 deficiency;
obstructive.

Symptoms of cerebellar ataxia

It is customary to distinguish two types of cerebellar ataxia: static (static-locomotor) and dynamic. Static cerebellar ataxia develops with damage to the cerebellar vermis, and dynamic - with pathology of the cerebellar hemispheres and its connections. Each type of ataxia has its own characteristics. Cerebellar ataxia of any kind is characterized by a decrease in muscle tone.

Static-locomotor ataxia

This type of cerebellar ataxia is characterized by a violation of the antigravitational function of the cerebellum. As a result, standing and walking become too much of a burden on the body. Symptoms of static-locomotor ataxia can be:

inability to stand straight in the “heels and toes together” position;
falling forward, backward or swaying to the side;
the patient can only stand with his legs wide apart and balancing with his hands;
staggering gait (like a drunk);
when turning the patient "carries" to the side, and he may fall.

Several simple tests are used to detect static-locomotor ataxia. Here are some of them:

standing in the Romberg position. The pose is as follows: the toes and heels are moved together, the arms are extended forward to a horizontal level, the palms are looking down with the fingers spread wide. First, the patient is asked to stand with his eyes open, and then with his eyes closed. With static-locomotor ataxia, the patient is unstable both with open eyes and with closed ones. If no deviations are found in the Romberg position, then the patient is offered to stand in the complicated Romberg position, when one leg must be placed in front of the other so that the heel touches the toe (maintaining such a stable posture is possible only in the absence of pathology from the cerebellum);
the patient is offered to walk along a conditional straight line. With static-locomotor ataxia, this is impossible, the patient will inevitably deviate in one direction or another, spread his legs wide apart, and may even fall. They are also asked to stop abruptly and turn 90 ° to the left or right (with ataxia, the person will fall);
the patient is offered to walk with a side step. Such a gait with static-locomotor ataxia becomes, as it were, dancing, the body lags behind the limbs;
test "asterisk" or Panov. This test allows you to identify violations with a mildly pronounced static-locomotor ataxia. The technique is as follows: the patient must consistently take three steps forward in a straight line, and then three steps back, also in a straight line. First, the test is carried out with open eyes, and then with closed eyes. If with open eyes the patient is more or less able to perform this test, then with closed eyes he inevitably turns around (there is no straight line).

In addition to impaired standing and walking, static-locomotor ataxia manifests itself as a violation of coordinated muscle contraction when performing various movements. This is called in medicine cerebellar asynergia. To identify them, several tests are also used:

The patient is asked to sit up abruptly from a prone position with arms folded across his chest. Normally, at the same time, the muscles of the trunk and the posterior thigh muscles contract synchronously, and the person is able to sit down. With static-locomotor ataxia, synchronous contraction of both muscle groups becomes impossible, as a result of which it is impossible to sit down without the help of hands, the patient falls back and simultaneously raises one leg. This is the so-called Babinsky's asynergy in the prone position;
Babinsky's asynergy in a standing position is as follows: in a standing position, the patient is offered to bend back, throwing his head back. Normally, for this, a person will have to involuntarily bend his knees slightly and straighten in the hip joints. With static-locomotor ataxia, neither flexion nor extension occurs in the corresponding joints, and an attempt to bend ends in a fall;
Ozhechovsky's test. The doctor extends his arms with palms up and invites the standing or sitting patient to lean on them with his palms. Then the doctor suddenly pulls his hands down. Normally, lightning-fast involuntary contraction of the muscles in the patient contributes to the fact that he either leans back or remains motionless. A patient with static-locomotor ataxia will not succeed - he will fall forward;
the phenomenon of the absence of a reverse shock (positive Stuart-Holmes test). The patient is offered to bend the arm in the elbow joint with force, and the doctor counteracts this, and then suddenly stops the counteraction. With static-locomotor ataxia, the patient's hand is thrown back with force and hits the patient's chest.

Dynamic cerebellar ataxia

In general, its essence lies in the violation of the smoothness and proportionality, accuracy and dexterity of movements. It can be bilateral (with damage to both hemispheres of the cerebellum) and unilateral (with pathology of one hemisphere of the cerebellum). Unilateral dynamic ataxia is much more common.

Some of the symptoms of dynamic cerebellar ataxia overlap with those of static locomotor ataxia. So, for example, this concerns the presence of cerebellar asynergia (asynergy of Babinsky lying and standing, tests of Ozhechovsky and Stuart-Holmes). There is only a slight difference: since dynamic cerebellar ataxia is associated with damage to the cerebellar hemispheres, these tests predominate on the side of the lesion (for example, if the left cerebellar hemisphere is affected, “problems” will be with the left limbs and vice versa).

Also, dynamic cerebellar ataxia manifests itself:

intenion tremor (tremor) in the extremities. This is the name of the trembling that occurs or intensifies towards the end of the movement performed. At rest, trembling is not observed. For example, if you ask the patient to take a ballpoint pen from the table, then at first the movement will be normal, and by the time the pen is taken directly, the fingers will tremble;
misses and misses. These phenomena are the result of disproportionate muscle contraction: for example, the flexors contract more than necessary to perform a particular movement, and the extensors do not relax properly. As a result, it becomes difficult to perform the most familiar actions: bring a spoon to your mouth, fasten buttons, lace up shoes, shave, and so on;
handwriting violation. Dynamic ataxia is characterized by large uneven letters, a zigzag orientation of the written;
scrambled speech. This term refers to the discontinuity and jerkiness of speech, the division of phrases into separate fragments. The speech of the patient looks as if he is speaking from the podium with some slogans;
nystagmus. Nystagmus is an involuntary tremulous movement of the eyeballs. In fact, this is the result of discoordination of contraction of the eye muscles. The eyes seem to twitch, this is especially pronounced when looking to the side;
adiadochokinesis. Adiadochokinesis is a pathological movement disorder that occurs in the process of rapid repetition of multidirectional movements. For example, if you ask the patient to quickly turn the palms against their axis (as if screwing in a light bulb), then with dynamic ataxia, the affected hand will do it more slowly and awkwardly compared to the healthy one;
the pendulum nature of the knee jerks. Normally, a blow with a neurological hammer under the patella causes a single movement of the leg of one degree or another. With dynamic cerebellar ataxia, leg oscillations are made several times after one blow (that is, the leg swings like a pendulum).

To identify dynamic ataxia, it is customary to use a number of samples, since the degree of its severity does not always reach significant limits and is immediately noticeable. With minimal lesions of the cerebellum, it can be detected only with samples:

finger test. With a straightened and raised to a horizontal level hand with a slight abduction to the side with open and then closed eyes, ask the patient to put the tip of the index finger into the nose. If a person is healthy, he can do this without much difficulty. With dynamic cerebellar ataxia, the index finger misses, when approaching the nose, intentional trembling appears;
finger test. With eyes closed, the patient is offered to hit each other with the tips of the index fingers of slightly apart hands. Similar to the previous test, in the presence of dynamic ataxia, no hit occurs, trembling may be observed;
thumb test. The doctor moves the neurological hammer in front of the patient's eyes, and he should hit the index finger exactly in the gum of the hammer;
test with hammer A.G. Panov. The patient is given a neurological hammer in one hand and the fingers of the other hand are offered to alternately and quickly squeeze the hammer either by the narrow part (handle), or by the wide one (gum);
heel-knee test. It is carried out in the supine position. It is necessary to raise the straightened leg by approximately 50-60 °, hit the heel with the knee of the other leg and, as it were, “ride” the heel along the front surface of the lower leg to the foot. The test is carried out with open eyes, and then with closed ones;
test for redundancy and disproportion of movements. The patient is asked to stretch his arms forward to a horizontal level with palms up, and then, at the doctor's command, turn his palms down, that is, to turn clearly 180 °. In the presence of dynamic cerebellar ataxia, one of the arms rotates excessively, that is, more than 180 °;
test for diadochokinesis. The patient should bend his arms at the elbows and, as it were, take an apple in his hands, and then quickly make twisting movements with his hands;
Doinikov's finger phenomenon. In the sitting position, the patient has relaxed hands on his knees, palms up. On the affected side, it is possible to bend the fingers and turn the hand due to an imbalance in the tone of the flexor and extensor muscles.

Such a large number of samples for dynamic ataxia is due to the fact that it is not always detected using only one test. It all depends on the extent of damage to the cerebellar tissue. Therefore, for a more in-depth analysis, several samples are usually carried out simultaneously.

Treatment of cerebellar ataxia

There is no single strategy for the treatment of cerebellar ataxia. This is due to the large number of possible causes of its occurrence. Therefore, first of all, it is necessary to establish the pathological condition (for example, stroke or multiple sclerosis) that led to cerebellar ataxia, and then a treatment strategy is being built.

The symptomatic remedies most commonly used for cerebellar ataxia include:

Help in the fight against cerebellar ataxia is exercise therapy and massage. Performing certain exercises allows you to normalize muscle tone, coordinate the contraction and relaxation of the flexors and extensors, and also helps the patient to adapt to new conditions of movement.

In the treatment of cerebellar ataxia, physiotherapeutic methods can be used, in particular electrical stimulation, hydrotherapy (baths), magnetotherapy. Classes with a speech therapist will help normalize speech disorders.

In order to facilitate the process of movement, a patient with severe manifestations of cerebellar ataxia is recommended to use additional means: canes, walkers and even wheelchairs.

In many ways, the prognosis for recovery is determined by the cause of cerebellar ataxia. So, in the presence of a benign tumor of the cerebellum after its surgical removal, a complete recovery is possible. Cerebellar ataxias associated with mild circulatory disorders and craniocerebral injuries, meningitis, meningoencephalitis are successfully treated. Degenerative diseases, multiple sclerosis are less amenable to therapy.

Thus, cerebellar ataxia is always a consequence of some kind of disease, and not always neurological. Its symptoms are not so numerous, and its presence can be detected with the help of simple tests. It is very important to establish the true cause of cerebellar ataxia in order to cope with the symptoms as quickly and effectively as possible. The tactics of managing the patient is determined in each case.

Neurologist M. M. Shperling talks about ataxia:

Some diseases develop on their own, while others are formed in addition to some other diseases as a complication or an obligatory phenomenon. Most often, such secondary ailments require special treatment - the elimination of symptoms and the correction of the main cause of their occurrence. Just such a disease is ataxia, we will discuss it, the main symptoms and causes of treatment.

What is ataxia in humans?

Ataxia in its essence is a serious violation of the coordination of movements, which is in no way interconnected with muscle weakness. Such a pathological phenomenon may concern the coordination of the limbs, and in some cases almost the entire body. In addition, the disease can disrupt the coordination of gait and cause problems with breathing and speech.

How does ataxia manifest itself, what are its symptoms?

There are several types of ataxia, which may differ in their manifestations. So the most common hereditary type of such an ailment is considered to be Friedreich's ataxia. The first manifestations of such a disease become noticeable in adolescence or adolescence. They include noticeable awkwardness and some uncertainty during walking, there is also weakness and atrophy of the muscles of the legs, the occurrence of discoordination in the hands.

Often such patients experience dysarthria, which is a violation of pronunciation due to a deficiency in the innervation of the speech apparatus. Over time, this ataxia leads to the development of diabetes mellitus, obesity, hypogonadism, cardiomyopathy, optic nerve atrophy and cataracts, scoliosis, hollow foot, etc.

With a vestibular variety of ataxia, the patient suffers from dizziness, which is often accompanied by nausea and vomiting, he is worried about nystagmus, and in some cases hearing loss. Symptoms increase if the patient turns his eyes or his torso or head takes a certain position. A characteristic sign of vestibular ataxia is staggering while walking with a deviation in a certain direction.

A sensitive type of ataxia leads to a violation of walking in the dark, the patient has difficulty maintaining balance, taking the Romberg position or simply closing his eyes. A patient with such an ailment walks with extreme caution, raising his leg high and lowering it to the surface of the floor with the entire sole.

Cortical actaxia leads to a change in gait, which becomes, as it were, "drunk". In the event that severe damage to the cerebral cortex occurs, the patient may suffer from paralysis, lose the ability to stand or walk. Also, the symptoms of this type of pathology include the appearance of olfactory and auditory hallucinations, mental changes, memory impairment and visual impairment.

Why does ataxia occur, what are the reasons for this?

There are many factors that can cause ataxia. Among these pathological conditions are various ailments of the brain (tumors, injuries, defects, acute circulatory disorders, hydrocephalus, and demyelinating ailments). Also, ataxia can be triggered by diseases of the vestibular apparatus - labyrinthitis, vestibular neuronitis, neuroma of the vestibular nerve.

In certain cases, the disease starts as a result of poisoning with sleeping pills or potent drugs, for example, benzodiazepines, barbiturates, etc. Experts say that it can also be caused by a serious deficiency of vitamin B12. In some cases, the disease has a hereditary origin.

How is ataxia corrected, what is it?

Therapy of ataxia is to correct the causes of its development. So, if the disease was provoked by disturbances in the activity of the brain or cerebellum, the doctor can perform an operative procedure - the elimination of tumor formation, hemorrhage or abscess. Measures can also be taken to reduce pressure in the region of the posterior cranial fossa, sometimes a decision is made to create an outflow from the CSF.

In certain cases, ataxia therapy involves the normalization of blood pressure, as well as taking drugs that optimize cerebral blood flow and metabolic processes. These drugs include angioprotectors, as well as nootropic drugs. Such measures help to cope with cerebral circulation disorders.

If infectious lesions of the brain or inner ear have been diagnosed, antibiotic therapy is carried out. With demyelinating ailments, the patient has to take hormonal medications (steroids), and the plasmapheresis procedure is also indicated.
To eliminate poisoning, they resort to the introduction of solutions and various vitamins, especially B vitamins, ascorbic acid and provitamin A.

Deficiency of cyanocobalamin requires its timely administration.

Friedreich's ataxia can be corrected by the use of drugs that can support mitochondrial function, such drugs include tocopherol, coenzyme Q10, riboflavin, and succinic acid.

symptomatic