Fukutake Toshio
Department of Neurology, Kameda Medical Center.
Rinsho Shinkeigaku. 2023 Apr 25;63(4):201-208. doi: 10.5692/clinicalneurol.cn-001820. Epub 2023 Mar 29.
Ataxia is not only due to cerebellar lesions, but also due to non-cerebellar lesions such as those in the brain, spinal cord, dorsal root (DR), peripheral nerve. In this article, optic ataxia is excluded and 'vestibular ataxia' is briefly referred. Non-cerebellar ataxias are generically called sensory ataxia or posterior column ataxia. However, since non-cerebellar lesions, e.g. frontal lobe lesions, may develop "cerebellar-like ataxia" (Hirayama, 2010). At the same time, non-posterior column lesions, e.g. parietal lobe lesion, can show "posterior column-like ataxia". From these viewpoints, I here describe various non-cerebellar ataxia in some disorders such as tabes dorsalis and sensory neuropathies and emphasize a role of a peripheral sensory input to the cerebellum via the DR ganglia and spinocerebellar tract for sensory ataxia because there is the International Consensus (2016) that the ataxia in Miller Fisher syndrome is suggested cerebellar-like clinicophysiologically.
共济失调不仅由小脑病变引起,也可由非小脑病变导致,如脑部、脊髓、背根(DR)、周围神经的病变。在本文中,排除了视觉性共济失调,并简要提及了“前庭性共济失调”。非小脑性共济失调通常被称为感觉性共济失调或后索共济失调。然而,由于非小脑病变,如额叶病变,可能会出现“小脑样共济失调”(平山,2010年)。同时,非后索病变,如顶叶病变,可表现出“后索样共济失调”。从这些观点出发,我在此描述一些疾病中的各种非小脑性共济失调,如脊髓痨和感觉神经病,并强调通过DR神经节和脊髓小脑束向小脑的外周感觉输入在感觉性共济失调中的作用,因为国际共识(2016年)表明,米勒·费希尔综合征中的共济失调在临床生理上提示为小脑样。