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Case Study 15.1: 70 y.o. janitor (mildly slurred speech with slowed tongue…
Case Study 15.1
: 70 y.o. janitor
L. dysmetria on finger-to-nose & heel-to-shin testing
L. arm & leg ataxia
Cerebellum
ipsilateral cerebellar lesion/infarct
MRI to check for infarction
mildly slurred speech with slowed tongue movements
dysfunction of CN XII
motor function to tongue
test by having patient stick out tongue and move to R & L
cerebellar lesion/infarct
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L. dysdiadochokinesia
Abnormal rapid alternating movements
Test by tapping one hand with the palm & dorsum of the other hand
could be cause by cerebellar lesion/infarct
sudden onset nausea, vomiting, & unsteadiness
cerebellar-vestibular circuits
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CN VIII dysfunction
Vestibular branch (balance)
Loose otoconia in the semicircular canals
Benign proximal positional vertigo (BPPV)
Falls to L. when standing even with eyes open
ataxia
cerebellar lesion/infarct
MRI to rule out infarct
History of hypertension