小脑参与感觉运动手术,认知任务和情感过程。这里,根据我们对小脑手术的理解的最新进展,我们重新审视小脑综合征的概念。小脑功能障碍的主要症状和体征,通常归入共济失调的通用术语,正在讨论。眩晕,头晕,失衡与前庭小脑的病变有关,前庭-脊髓,或小脑眼运动系统。小脑在眼睛运动的在线到长期控制中起着重要作用(校准的控制,减少眼睛不稳定,眼睛对齐的维护)。眼不稳定,眼球震颤,扫视侵入,受损的平滑追求,前庭眼反射受损(VOR),和眼睛错位是动眼小脑缺陷的核心。作为一种运动性言语障碍,共济失调构音障碍高度提示小脑病理。关于四肢的运动控制,低张力,-或运动障碍,dysmetria,在小脑疾病中观察到不同程度的抓握缺陷和各种震颤现象。有明确的证据表明,小脑在主动运动过程中参与了力觉和本体感觉。步态惊人,基础广泛,在小脑疾病中,串联步态经常受损。在认知和情感操作方面,缺陷存在于执行功能中,视觉空间处理,语言功能,和情感调节(Schmahmann综合征)。非运动语言障碍,包括发音和图形运动规划的中断,语言动态,口语流利,语音,和语义词检索,表达性和接受性语法,小脑损伤后,阅读和写作的各个方面都可能受损。小脑被组织成(a)前叶和小叶VI相邻部分的主要感觉运动区域,(b)小叶VIII中的第二感觉运动区域,和(c)位于后叶的认知和边缘区域(小叶VI,小叶VIIA,包括短肢I和短肢II,和小叶VIIB)。边缘小脑主要表现在后椎。小脑-小脑和小脑-丘脑-皮层环路在小脑和幕上运动之间建立了紧密的功能连接,旁视和联想皮层,小脑症状与这些环路的中断有关。
The cerebellum is involved in sensorimotor operations, cognitive tasks and affective processes. Here, we revisit the concept of the cerebellar syndrome in the light of recent advances in our understanding of cerebellar operations. The key symptoms and signs of cerebellar dysfunction, often grouped under the generic term of ataxia, are discussed. Vertigo, dizziness, and imbalance are associated with lesions of the vestibulo-cerebellar, vestibulo-spinal, or cerebellar ocular motor systems. The cerebellum plays a major role in the online to long-term control of eye movements (control of calibration, reduction of eye instability, maintenance of ocular alignment). Ocular instability, nystagmus, saccadic intrusions, impaired smooth pursuit, impaired vestibulo-ocular reflex (VOR), and ocular misalignment are at the core of oculomotor cerebellar deficits. As a motor speech disorder, ataxic dysarthria is highly suggestive of cerebellar pathology. Regarding motor control of limbs,
hypotonia, a- or dysdiadochokinesia, dysmetria, grasping deficits and various tremor phenomenologies are observed in cerebellar disorders to varying degrees. There is clear evidence that the cerebellum participates in force perception and proprioceptive sense during active movements. Gait is staggering with a wide base, and tandem gait is very often impaired in cerebellar disorders. In terms of cognitive and affective operations, impairments are found in executive functions, visual-spatial processing, linguistic function, and affective regulation (Schmahmann\'s syndrome). Nonmotor linguistic deficits including disruption of articulatory and graphomotor planning, language dynamics, verbal fluency, phonological, and semantic word retrieval, expressive and receptive syntax, and various aspects of reading and writing may be impaired after cerebellar damage. The cerebellum is organized into (a) a primary sensorimotor region in the anterior lobe and adjacent part of lobule VI, (b) a second sensorimotor region in lobule VIII, and (c) cognitive and limbic regions located in the posterior lobe (lobule VI, lobule VIIA which includes crus I and crus II, and lobule VIIB). The limbic cerebellum is mainly represented in the posterior vermis. The cortico-ponto-cerebellar and cerebello-thalamo-cortical loops establish close functional connections between the cerebellum and the supratentorial motor, paralimbic and association cortices, and cerebellar symptoms are associated with a disruption of these loops.