Cerebellar Manifestations

Disturbances resulting from both vermian and hemispheric cerebellar lesions are common in MS. Gait ataxia was an initial complaint in 13% in one series (36). Although common in patients with chronic disease, its incidence is difficult to discern from published series because many patients are included under vague categories, such as balance. Examination may show appendicular ataxia, dysmetria, intention tremor on finger-nose-finger test, or dysdiadochokinesia when the patient tries to perform rapid, alternating movements. Dysmetria on the heel-knee-shin test is also frequently present. At times, the tremors, present even at rest, may assume violent proportions with attempted movement (so-called rubral tremor). Limb ataxia or intention tremor has been reported in 45% to 50% of patients with chronic disease (37,39).

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