Compendium of regional diagnosis in affectations of the brain and spinal cord / Translated by F.S. Arnold.

  • Bing, Robert.
Date:
1913
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Licence: In copyright

Credit: Compendium of regional diagnosis in affectations of the brain and spinal cord / Translated by F.S. Arnold. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    Further, the optic thalamus and the red nucleus of the tegmentum send, as we have seen, the thalamo-spinal and the rubro-spinal tracts (Monakow's bundle) to the cells of the ventral horn. As, however, a strong contingent of efferent fibres from the cerebellum passes through the superior cerebellar peduncles (hrachia conjunctiva), to the cells of origin of these tracts, they are held to play a part in the cerebellar regulation of motor impulses, analogous to that of the vestibulo-spinal tracts. The cerebellum, then, to summarize, provides, by means of the spino-cerebellar tracts and the system of the nucleus of Deiters, for the perception of the position of our body, limbs, head, and optic axes ; while, by means of the vestibulo- spinal, thalamo-spinal, and rubro-spinal tracts, and the dorsal longitudinal bundle, it regulates the innervation of our trunk, limb, and eye muscles, in such manner as to secure a continuous and harmonious maintenance of equi- librium in standing or walking. Cerebellar ataxia, therefore, a typical disturbance of co-ordination, is by far the most important symptom of cerebellar affections. In contrast with posterior root ataxia, in which all movements exhibit loss of co-ordination, cerebellar ataxia affects specially the larger movements, movements in- volving wide co-operation among groups of muscles, espe- cially of the trunk and lower extremities. Single move- ments, such as flexion and extension of the foot, knee, and hip, abduction and adduction of the thigh, may be correctly executed. Their static and dynamic co-ordination, however, is interfered with in such a manner as to produce a zigzag gait, like that of a drunken man, while the power of stand- ing in an erect posture is impaired by a more or less marked tendency to stagger. The separate trunk and limb muscles can no longer co-operate correctly in maintaining rest and stability simultaneously. This cerebellar asynergia may reveal itself also by a tendency, while walking forwards, for the head and trunk to lag behind, to fall backwards—a ten- dency which may so seriously disturb the equilibrium of the body, as to bring about a fall ; or, again, in rising from the supine position, the legs may be lifted instead of the body, and so on.