Clinical Syndromes seeTables173 and 174

Pure cerebellar syndromes are rare. Cerebellar disorders often affect more than one of the functionally different subdivisions of the cerebellum and involve the medulla and pons early either directly or indirectly by pressure or obliteration of vessels. Pressure effects are common in the posterior fossa, where expansion is anatomically limited. There is no difference between the symptoms of ataxia that result from lesions of the cerebellar peduncles and those that result from damage to the cerebellum itself. A remarkable degree of compensation occurs in lesions of the cerebellum, which are particularly marked in children and slowly progressive disorders. On clinical grounds, the cerebellum might be divided into three functional divisions. Disturbances of gait result from lesions in all three divisions, the flocculonodular, the anterior, and posterior lobes of the corpus cerebelli. Ataxia of voluntary movements are disturbances resulting exclusively from lesions of the lateral parts of the posterior lobe.

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