How the Cerebellum Works
The cerebellum is like a “mini-brain” when it comes to movement. The cerebellum plays an important role in:
Balance Smooth, coordinated movement Vision (coordinated eye movement) Motor learning: The cerebellum helps the body learn movements that require practice and fine-tuning. Mental functions: Researchers believe the cerebellum plays a role in thinking, including processing language and mood.
The Cerebellum and MS
When your cerebellum is damaged, nerve cells break down and die. MS and other diseases that damage your cerebellum can cause problems such as:
Ataxia: Loss of control of voluntary movement, i. e. , the ability to move your body the way you want Unsteady gait: A person with cerebellar damage is likely to walk unsteadily, even clumsily. He or she may look drunk, even though that isn’t the case. Cognitive impairment: This includes a reduction in your conscious mental activities, such as thinking, learning, memory, and concentration. About 40 percent to 65 percent of people with MS have cognitive impairment, making it a core symptom of the disease. In approximately 11 percent of that group, the cerebellar symptoms are the strongest indication that a person has MS. Fatigue, depression, and physical disability in MS can make problems with memory and processing speed worse.
In a person with advanced MS, movement problems together with spasticity (muscle tightness or stiffness) may cause severe physical disability.
In addition, the ongoing damage to the cerebellum may lead to slurred speech, “scanning” speech (slow forming of words and pauses between words or syllables), and what’s known as the Charcot triad, which consists of scanning speech, nystagmus (rapid and involuntary eye movements), and intention tremor.
Because of the location of the cerebellum, lesions in this region are sometimes hard to detect with standard magnetic resonance imagining (MRI). In a 2015 study, researchers were able to use more sophisticated imaging techniques and cerebellar lesions were found in the majority of study participants with MS.
A Word From Verywell
Treatments for cerebellar symptoms of MS are currently the same as those for other manifestations of the disease, such as disease-modifying therapies (DMTs), which aim to reduce the burden of disease. Otherwise, treatments are geared toward specific symptoms. Ataxia and balance problems, for example, can be managed by physical therapy involving specific core strengthening exercises.
If you are experiencing problems with balance, gait, and cognition, talk to your healthcare provider about the best strategies for controlling these symptoms. You can use our Healthcare Provider Guide below to help you start that conversation.
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