Dichgans J
Hum Neurobiol. 1984;2(4):269-79.
The clinical symptoms of cerebellar dysfunction are reviewed in relation to modern concepts of cerebellar physiology. Special attention is given to their topodiagnostical significance. Hypotonia, hyporeflexia, asthenia, delayed onset and offset as well as slowing of voluntary movement, ataxia, dysmetria, tremor and myoclonus result from damage of the lateral cerebellar hemispheres and the dentate nucleus. Three different key patterns of postural ataxia result from lesions of the anterior lobe, the vermal part of the vestibular cerebellum and dysfunction of cerebellar afferences respectively. The long latency response (M3) is significantly prolonged in patients with anterior lobe atrophy. Oculomotor symptoms mainly result from either lesions of the cerebellar flocculus, causing dysfunction of retinal-image stabilization or from damage to the dorsal vermis (VI and VII) and the fastigial nuclei, resulting in saccadic dysmetria.
本文结合现代小脑生理学概念，对小脑功能障碍的临床症状进行了综述。特别关注了它们在定位诊断方面的意义。小脑半球外侧和齿状核受损会导致肌张力减退、反射减弱、肌无力、运动起始和终止延迟以及随意运动减慢、共济失调、辨距不良、震颤和肌阵挛。前叶、前庭小脑蚓部病变以及小脑传入功能障碍分别导致三种不同的姿势性共济失调关键模式。前叶萎缩患者的长潜伏期反应（M3）显著延长。动眼神经症状主要源于小脑绒球病变导致视网膜图像稳定功能障碍，或源于小脑蚓部背侧（VI和VII）及顶核受损导致眼球扫视辨距不良。
