CEREBELLAR DISEASE.
Cerebellum and coördination. Pressure on adjacent parts renders results uncertain. Generic symptoms, ataxia, titubation. Marked symptoms with rapid morbid progress. Treatment: tonic, hygienic.
Whatever functions are exercised by the cerebellum there is no doubt of its control over muscular coördination. It is quite true that disease of any other part of the brain causing effusion, exudation or intracranial pressure will more or less completely arrest the functions of the cerebellum just as disease of the cerebellum producing intracranial pressure will derange the functions of other parts of the encephalon. The general symptoms produced in this way cannot therefore be accepted as indicating the precise localization of an intracranial disease. Dullness, stupor, coma, dilated pupils, choked discs, optic neuritis, and vomiting, are in this sense generic symptoms, which may in the absence of fever indicate dropsy, exudation, apoplexy, tumor, concussion or other lesion, and with hyperthermia may indicate encephalitis or meningitis. But if in the absence of these symptoms and of aural disease there should appear ataxia, swaying unsteady gait, and staggering, there is a strong presumption of cerebellar disease. This may also be manifested by the other and generic symptoms already mentioned only the diagnosis is not then so certain. Again cerebellar disease may exist without the ataxia and lack of balance, but probably only in cases in which the progress is slow and the organ has had ample time to accommodate itself to the as yet comparatively restricted lesions. The result may be a mere defect of muscular tone, or it may extend to an almost absolute loss of contractility, or it may be of any intermediate grade.
Treatment, which is eminently unsatisfactory, consists in improving the general health and tone, by corroborant medicines and conditions of life, and training the muscles by carefully graduated exercise and even electricity.