Cerebellar Functions

A 52-year-old man presents with acute onset of gait ataxia, dysmetria of the right limbs, and nystagmus following a right cerebellar stroke. All of the following cerebellar structures are involved in the motor deficits observed EXCEPT:

A 38-year-old woman from Bangalore is evaluated for progressive clumsiness over 6 weeks. She reports difficulty with rapid alternating movements of her hands and feet. On examination, she performs finger-to-nose and heel-to-shin tests with marked overshoot and oscillation of the limbs. She also demonstrates dysdiadochokinesia (inability to perform rapid alternating pronation-supination of the forearms). Her gait is relatively preserved, and she has no vertigo. Fundoscopy reveals no optic atrophy. MRI brain shows focal lesion in the right cerebellar hemisphere. Which of the following BEST explains the patient's clinical findings?

A 52-year-old man with chronic alcohol use disorder presents with gait ataxia, nystagmus, and dysarthria. Imaging reveals selective degeneration of the cerebellar vermis. Which is the most common site of cerebellar pathology in chronic alcoholism?

A 58-year-old man presents with a 3-month history of progressive gait disturbance, intention tremor, and dysarthria. MRI brain shows a 4 cm mass in the right cerebellar hemisphere with surrounding edema. He is neurologically intact otherwise. What is the most appropriate next step in management?

A 42-year-old woman with spinocerebellar ataxia type 1 (SCA1) presents with progressive ataxia, nystagmus, and dysarthria over the past 2 years. She has difficulty with balance and coordination. Genetic testing confirms the diagnosis. What is the most appropriate next step in management?