Coordination Impairments in Cerebellar and Basal Ganglia Pathology

Study Notes

Common Coordination Impairments

Asthenia
- Cerebellar pathology leads to generalized muscle weakness.
- Basal ganglia pathology causes inability to initiate movement, often resulting in fixed postures.
Asynergia
- Defined as the loss of coordinated muscle association for complex movements in cerebellar disorders.
- Basal ganglia pathology presents as slow, involuntary writhing movements, especially impacting distal upper extremities.
Delayed Reaction Time
- Cerebellar dysfunction characterized by increased time to initiate voluntary movements.
- In basal ganglia pathology, results in decreased amplitude and velocity of voluntary movements.
Dysarthria
- Motor speech articulation disorder associated with cerebellar dysfunction.
- Basal ganglia involvement leads to rapid, irregular jerky movements affecting multiple joints, particularly in upper extremities.
Dysdiadochokinesia
- Impaired rapid alternating movements due to cerebellar pathology.
- Basal ganglia disorders feature movement disruptions resembling chorea and athetosis.
Dysmetria
- Inability to accurately judge movement distance or range in cerebellar conditions.
- In basal ganglia dysfunction, manifests as sustained involuntary contractions of both agonist and antagonist muscles.
Dyssynergia
- Movement occurs in separate components instead of as a fluid action under cerebellar pathology.
- Basal ganglia conditions may cause large-amplitude, violent flailing motions of one side's arm and leg.
Gait Disorders
- Cerebellar ataxic gait features a broad stance, postural instability, and high-guard position.
- Basal ganglia involvement leads to increased muscle activity or abnormal movement patterns.
Hypotonia
- Reduction in muscle tone observed in cerebellar conditions.
- Basal ganglia lesions result in a decreased motor response, especially in reaction to specific stimuli.
Hypermetria
- Seen in cerebellar disorders, leading to overestimation of movement distance.
- Basal ganglia pathology increases muscle tone, creating resistance to passive movement, particularly in flexors.
Hypometria
- Underestimation of distance during movement tasks in cerebellar impairments.
- In basal ganglia dysfunction, characterized by constant resistance as limbs move.
Nystagmus
- Eye movement disorder with rhythmic, quick oscillatory motion in cerebellar issues.
- Basal ganglia conditions may present as brief relaxations or "catches" when the limb is moved.
Rebound Phenomenon
- Inability to halt sudden limb movements found in cerebellar impairment.
- Basal ganglia disorders result in involuntary rhythmic oscillations observed at rest.
Tremor Types
- Intention (kinetic) tremor affects movement control when opposing muscle forces are present.
- Postural (static) tremor involves involuntary oscillation due to alternating contractions, often diminishing at rest.
- Titubation refers to oscillatory movements during voluntary motion, increasing as the target is approached.
Akinesia
- Characterized by exaggerated body oscillation in standing or when holding a limb against gravity, often associated with basal ganglia dysfunction.
Athetosis
- Involves rhythmic head and trunk oscillations resulting from basal ganglia conditions.
Bradykinesia
- A hallmark of basal ganglia pathology, typically leading to slowness of movement and reduced amplitude.
Chorea
- Characterized by rapid, irregular, and unintentional movements, principally connected to basal ganglia dysregulation.
Choreoathetosis
- A combination of chorea and athetosis, often seen in conditions related to the basal ganglia.
Dystonia
- Involves sustained muscle contractions resulting in abnormal postures, primarily associated with basal ganglia conditions.
Hemiballismus
- Characterized by violent, flinging movements, typically stemming from unilateral basal ganglia lesions.
Hyperkinesis
- Increased movement activity, often related to basal ganglia dysfunction.
Hypokinesis
- Decreased movement amplitude commonly observed in basal ganglia pathology.
Rigidity
- Increased muscle tone exhibiting two forms: lead-pipe rigidity (constant resistance) and cogwheel rigidity (intermittent resistance).
Resting Tremor
- Observed primarily in conditions related to basal ganglia, generally noticeable when the limb is at rest.

Description

Explore the common coordination impairments associated with cerebellar and basal ganglia pathology in this quiz. Understand how conditions like asynergia and asthenia affect movement and coordination. Test your knowledge on the differences between these two types of impairments and their clinical implications.