Cerebellar diseases

Proven content

You have heard about worm flooding more than once. The common understanding of this saying is about drowning your sadness in alcohol. But you can also accept a different interpretation. Alcohol disturbs the flow of information that reaches the cerebellum, which is responsible for maintaining balance, correct speech, etc.

The human cerebellum is shaped like a flattened ellipse. It is located in the posterior fossa of the skull, between the hemispheres of the brain. There is a flatter upper surface of the cerebellum and a strongly convex lower surface. The paired parts of the cerebellum are called the cerebellar hemispheres due to their similarity to the hemispheres of the brain. In the center is an odd part, called the cerebellar worm. The upper, middle and lower branches of the cerebellum depart from the cerebellum. Thanks to them, the cerebellum maintains connections with neighboring structures.

Due to the functions performed by individual parts of the cerebellum, an additional division of the cerebellum was performed in the anatomy.

Vestibular cerebellum – is responsible for maintaining balance and eye movements. Here come signals about the position of the head in relation to the whole body. Damage to this part of the cerebellum manifests itself with imbalances. The patient has difficulty maintaining an upright position, staggers, walks with legs wide apart.

Spinal cerebellum – is responsible for motor coordination.

New cerebellum – for planning movements and muscle tension.

Provision of information

The cerebellum receives information from many brain centers, analyzes it quickly and modulates it accordingly to make movements smooth and accurate. He decides which muscles to activate and which to stay still. For example – we see a large cardboard, so we think it will be heavy. We do not know, however, that it is empty inside. The cerebellum decides that a lot of force will be needed to move the box. If we gripped the cardboard with great force, instead of lifting it quietly, we would throw it upwards. But it doesn’t. In a fraction of a second, the cerebellum reduces the applied force. Changes the tone of skeletal muscles to restore balance of movement, proper muscle tone, etc.

The cerebellum is responsible for motor coordination, balance, muscle tension, learning motor behavior (e.g. cycling), it determines the smoothness and precision of movements. The cerebellum also receives information from: locomotor organs (muscles, joints and ligaments), skin, eyes, hearing, feet, the cortex of the brain, and the spinal cord. All this provides him with knowledge about the condition of the motor organs, about the currently performed movement, about disturbances in the balance of the body.

However, this is only part of all its secrets. It probably also influences our emotions and is involved in the learning process. There are billions of cells in the cerebellum, and billions of connections allow this powerful “processor” to process thousands of information within milliseconds, specifying the body movements initiated in the cerebral cortex. Thanks to it, the secretary types several hundred characters per minute on the computer keyboard, and the surgeon makes precise cuts with a scalpel. The cerebellum is also essential for balance. We don’t realize it as long as it works well. It’s only when something starts to go wrong that we see the precision and complexity of the processes that guide it.

Cerebellar syndrome

When the cerebellum does not function with the required precision, we are dealing with a disease called the cerebellar syndrome. The symptoms of the disease are disturbances in gait and balance, clumsiness (clumsiness) of movements professionally called ataxia and decreased muscle tone. The person is staggering, falling backwards or staggering while standing or walking. Damage to the cerebellar hemispheres causes the body movements to become incorrectly coordinated. A typical example is when you try to touch the tip of your nose with your finger. In a patient with a damaged cerebellum, the finger misses the target. This is accompanied by the so-called intentional tremor, most noticeable when the hand comes closer to the nose. The symptom of the cerebellar syndrome is also called chanted speech. It lacks natural fluency, is slow, and the words spoken are syllable and incorrectly stressed. There is also nystagmus, i.e. rhythmic, independent of our will eye movements in one direction. If the cerebellum is severely damaged, the muscles are flaccid and the nervous reflexes are weakened, the easiest way to check is by hitting the kneecap with a neurological hammer.

Not only alcohol

Staggering, slurred speech, and difficulty in balancing are familiar symptoms of alcohol abuse, but also cerebellar dysfunction following alcohol intoxication. If we consume alcohol occasionally, apart from a hangover the next day, we will not hurt ourselves much. But heavy drinking can permanently damage the cerebellum. Addiction to alcohol causes the body to lack vitamin B1, or thiamine. The cerebellum is the area particularly sensitive to the deficiency of this vitamin. By supplying vitamin B1 from the outside, we can prevent the disease to a certain stage, but it is only a temporary measure.

But similar symptoms can occur in people who do not drink alcohol. If we happen to meet a staggering person who cannot speak clearly and we do not feel alcohol from him – let’s help him. Ignoring such symptoms may end badly, because this is how a stroke manifests itself in the cerebellum. Acute cerebellar syndrome is also a consequence of poisoning with antiepileptic drugs, after an injury, and when an organ abscess develops.

Chronic diseases of the cerebellum

They are usually of an innate character. This is the case with Arnold-Chiari syndrome. Type I of this disease may not appear until adulthood. Then – usually after sudden sneezing, coughing or intense exertion – symptoms of cerebellar syndrome with neck pain, dizziness, difficulty swallowing appear. The reason is that part of the cerebellum has been pulled into the area of ​​the underlying spinal canal, and this in turn is due to too small or deformed skull.

Another congenital disorder is Friedreich’s ataxia. This disease affects not only the cerebellum, but also other parts of the nervous system and the heart. Doctors say the cause is a lack of an iron-binding protein called frataxin in the mitochondria. The more free iron, the more free radicals that damage cells.

There are also diseases of the cerebellum leading to its degeneration or disappearance. Their cause is not precisely identified. The list of these diseases includes – cerebellar cortex atrophy, multi-system atrophy, and oligo-pontocerebellar atrophy. All of them lead to loss of coordination, balance and speech disorders. After all, they completely immobilize the sick person. The cerebellum can be damaged in the presence of hypothyroidism, multiple sclerosis and neoplasms affecting this area. Prion diseases are very rarely the cause of chronic cerebellar damage.

Big hopes

Hope for a breakthrough in the treatment of cerebellar diseases is seen in research on stem cells, because the currently used methods of treatment are not satisfactory. It is much better with diagnostics. Magnetic resonance imaging is used to diagnose cerebellar diseases, which allows you to see all the fragments of the cerebellum.

However, without understanding the causes of the malfunctioning of the cerebellum, it is difficult to conduct effective treatment.

For example, an alcoholic is given vitamin B1 and urged to quit drinking. In Friedreich’s ataxia, attempts are made to use antioxidants – coenzyme Q10 or vitamin E to great effect. In the treatment of Arnold-Charie syndrome, a surgical procedure is performed – decompression of the posterior fossa of the skull, thanks to which the symptoms of the disease disappear.

Scientists have high hopes for stem cells. Perhaps finding a method that will force stem cells to transform into cells of the nervous system will change the fate of patients.

Cannibal disease

Kuru is the name of a very rare and deadly disease of the cerebellum. The kuru epidemic was observed in the 50s and 60s among the Fore mountain tribe living in New Guinea. It has been proven that the disease was a consequence of cannibalism, which involved relatives of the deceased eating its organs, including the brain. The disease was also spread by rubbing the brain into the skin. This extremely contagious ailment took a long time to breed. When the first symptoms appeared (gait disturbances, tremors, swaying, nystagmus, inability to walk, speech disorders, immobility), there was no rescue. Death happened very quickly. After much detailed research, kuru has been proven to be one of the diseases caused by prions, or infectious proteins. Creutzfeldt-Jakob disease and mad cow disease are included in the same group.

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