Holmes fully described symptoms of the lateral parts of the posterior lobe in his classic studies of injuries of the cerebellum. In unilateral lesions, the symptoms occur on the side of the lesion. Diseases of the cerebellar hemisphere (neocerebellum or pontocerebellum) due to hemorrhage, infarction, or neoplasms are correlated with severe disturbances of limb movements, including hypotonia in acute lesions, asynergia, dysdiadochokinesis, and if the dentate nucleus is involved, kinetic tremor. Occlusion of the SCA is likely to affect the fibers in the brachium conjunctivum with resultant ipsilateral limb ataxia. Past-pointing and deviation of gait to the affected side are associated
symptoms. Unilateral ataxia is present in the homolateral upper and lower extremity. Truncal and Bilateral Limb Ataxia
Symmetrical involvement of both hemispheres and vermis produces bilateral limb ataxia and ataxia of stance and gait, as happens in most forms of cerebellar degeneration. Dysarthria and oculomotor disturbances are also frequently present. Extracerebellar signs are often associated, such as pyramidal and extrapyramidal signs, ophthalmoplegia, and peripheral neuropathy.
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