localisation of cerebellar lesions

Last reviewed 01/2018

Cerebellar disease may be the result of lesions which affect:

  • the cerebellum
  • the input from proprioceptors, inner ear and cerebral hemispheres
  • the output from the cerebellum, which passes via the superior cerebellar peduncles

The clinical features of lesions in different locations is outlined below:

Midline cerebellar lesions affect:

  • anti-gravity reflexes
  • gait and stance ataxia
  • little limb ataxia

Lesions in the superior cerebellar peduncle (outflow lesions) cause:

  • intention tremor

Lesions in the midbrain, pons and medulla (inflow & outflow lesions) cause:

  • ataxia and/or intention tremor
  • other localising brainstem signs e.g. cranial nerve palsies

Ref: Essential Neurology, Wilkinson, I.M.S., 1993, 2nd edition, Blackwell Scientific Publications, p.114