A child presented with weakness of limbs, cannot sit properly and swaying both sides while walking. The lesion is in
(A) Cerebellar vermis # Cerebellum has 3 parts:> Archicerebellum (Vestibulocerebellum): It includes Flocculonodular lobe, which is located in the medial zone. Archicerebellum helps maintain equilibrium and coordinate eye, head, and neck movements; it is closely interconnected with the vestibular nuclei.> Midline vermis (Paleocerebellum): It helps coordinate trunk and leg movements. Vermis lesions result in abnormalities of stance and gait> Lateral hemispheres (Neocerebellum): They control quick and finely coordinated limb movements, predominantly of the arms.> Localization and regional distribution of pathology within the cerebellum dictates the clinical findings: Lesions of the midline cerebellar vermis produce truncal tremor and gait ataxia (splayed stance and swaying of the body while walking). Lesions of the cerebellar lateral hemispheres produces a limb ataxia & result in loss of muscular coordination and jerky puppet-like movements of the limbs on the ipsilateral side (same side as lesion).> Interruption of afferent and efferent connections within the neocerebellar system: Results in an ataxic gait (i.e., swaying in the standing posture, staggering while walking with a tendency to fall, and the adoption of a compensatory wide base), scanning dysarthria, explosive speech, hypotonia, intention tremor (i.e., oscillation of limbs that is pronounced at the end of a planned movement), dysdiadochokinesia (i.e., impaired alternating movements), dysmetria (i.e., impaired judgment of distance), decomposition of movement, and abnormalities of eye movements (i.e., nystagmus). Small lesions produce no signs or only transient symptoms; small deficits are compensated for by other parts of the brain.CEREBELLAR DYSFUNCTION: ANATOMYCerebellar LesionSigns* Posterior (Flocculo-nodular lobe Archicerebellum)Eye movement disorders: Nystagmus; Vestibulo-ocular Reflex (VOR)* Midline (Vermis; Paleocerebellum)Truncal & Gait Ataxia* Hemisphere (Neocerebellum)Limb ataxia: Dysmetria, Dysdiadochokinesis, 'intention' tremorDysarthriaHypotonia
Cerebellar vermis
Cerebellar hemisphere
Cerebellopontine area
Neocerebellum
Miscellaneous