Assessing Dysmetria as a Neurological Condition
Introduction
Beukelman et al. (2007) defined Neurological conditions as disorders that majorly affect the brain, the spinal cord or the nerves of a human being. These disorders have a range of causes that the report found out. The causes included genetic aspects, traumatic injuries and other infections. It was noted that causes of some of these disorders have not been known or well understood yet. There is a large number of neurological conditions, and they may be grouped into four broad types. Sudden onset group includes disorders like stroke, spinal injury or meningitis, intermittent examples include disorders like epilepsy and migraine. The progressive type consists of Parkinson’s disease and dementia. The final group is ‘stable with changing needs’ that provides for disorders such as narcolepsy and Tourette syndrome. It has been discovered that neurological conditions have a significant effect on the quality of life and day to day activities of an individual.
Pathophysiology
Schmahmann (2004) alluded that the word pathophysiology is made up of Greek words “pathos” which means suffering “physis” means nature or the origin and “logos” which is “the study of”. The term pathophysiology, therefore, refers to the analysis or study of abnormal variations in the body functioning that are causes or results of a disease process. Pathophysiology is the collaboration of pathology with physiology to study the disorder. Pathology is a medical approach that analyses conditions that are observed during a state of a particular disease. At the same time, physiology is the discipline that defines mechanisms that operate within a living organism. Pathology seeks to explain the abnormal condition in a living organism. In contrast, pathophysiology aims to describe or explain the functional changes that come about in that living organism as a result of a disease or the pathological state. It was noted pathophysiology is the study of physical and biological abnormalities that occur within the body as a result of a disease. Dysmetria is a disorder that is characterized by the inability to make movements of the appropriate distance. Vattikuti and Chow (2010) described dysmetria as the inability to perform accurate actions. The inability is characterized by patients overshooting (hypermetria) or undershooting (hypometria). Dysmetria is caused when the cerebellum fails to function well. The cerebellum is the part of the brain that allows an individual to make coordinated movements and process thoughts as well as behaviours (Huangetal 2010)
Signs and Symptoms of Dysmetria
Kobayashi et al. (2010) alluded that a person with saccadic dysmetria will frequently produce abnormal eye movements even if the eye is at rest. During the process of eye movement, hypometric and hypermetric saccades occur that will lead to the slowing down of normal eye or saccadic movement. Poor coordination of the body parts is also another primary symptom of dysmetria. Lack of coordination leads to unsteady walking and complete lack of balance and a tendency to stumble when walking. Patients with dysmetria experience difficult when carrying out light tasks like eating, writing or even picking up something light from the table or the floor. Patients with dysmetria may also have a slowed speech as another symptom. This is because the vocal coordination has been impared thus slowing down the responses. Apart from slowed-down eye movement, dysmetria also causes the involuntary back and forth eye movements (Van der Geest et al.2004). Another noticeable symptom of dysmetria is having difficulties in swallowing of food and drinks. Finally, patients may have difficult in pronounciation of some words or complete inability to produce sounds properly (Scarratt 2004).
Effects on Movement and Control
Manto (2009) asserted that so many strategies are required for an individual to perfom motion accurately. This includes use of muscles, joints and several interactions with the sorroundings. The cerebellum is critical in action control and movement. Part of the cerebellum controls the movement rate and the coordination components. Dysmetria leads to reduced or lack of accuracy in the voluntary movements of an individual. The most common form of dysmetria is the hypermetria which is defined as overshooting of an aimed target during voluntary movements. Dysmetria patients also show cases of undershooting before a target, this is called hypometria. In dysmetria patients, the initiation of movement is delayed thus impairing or slowing down movement actions. The disorder occurs mainly in the lower and upper limbs thus affecting both single and multi-joint movements. It was noted that in the early stages of dysmetria, balance was poor and there was the inability to stand on one leg. As the condition advances, walking become a problem as well as turning and could always result into falling by the patients. Characteristically, high stepping, staggering and lurching from side to side was observed in patients. When the disorder is savere, individuals may no longer walk or even stand.
Treatment and Intervention
The report found out that dysmetria itself cannot be cured because it is actually a symptom of a disorder in a patient. A doctor could only control the symptom by treating whetever factor that caused it. Likewise, a patient would make adjustments in lifestyle to live with the disorder. As control measures from the doctor, the report noted that doctors would recommend physical or occupational therapy to help a patient live with the condition. Assistive devices are also adviced for the patients an example being the use of weighted plates to help patients eat. In a few cases, patients can be treated with prescription of drugs and high doses of vitamin E and gluten-free diets. Medics can also encourage regular physical exercises by the patients though light exercise are recommended. Shimizu (2008) stated that underwater exercise improves cerebellar ataxia that helps boost coordination and thus, improve body movement and control. Rasotto et al.(2015) alluded that physical activity or exercise program in astudy carried out was of much help to subjects diagnosed with dysmetria as it reduced symptoms of upper limb related disorders.
Conclusion
Dysmetria is a movement related disorder that affects the coordination of the body to yield total lack of control and involuntary eye movements. Difficulties in swallowing is also a symptom of dysmetria. The disorder itself has no cure but patients may be treated through use of drugs and use of vitamin E and gluten-free diets. Regular physical exercise may also be helpful in treating the disorder.
Recommendation
The report recommends that dysmetria is a neurological condition that should be evaded by individuals through regular body exercise and ensuring balanced diet is used. Regular visits to doctors may be of much help in preventing this disorder too.
References
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Kobayashi, S., Negishi, Y., Ando, N., Ito, T., Nakano, M., Togari, H. … & Taniguchi, K. (2010). Two patients with acute rotavirus encephalitis associated with cerebellar signs and symptoms. European journal of pediatrics, 169(10), 1287-1291.
Vattikuti, S. and Chow, C.C., 2010. A computational model for cerebral cortical dysfunction in autism spectrum disorders. Biological psychiatry, 67(7), pp.672-678.
Huang, T., Liu, Y., Huang, M., Zhao, X., & Cheng, L. (2010). Wnt1-cre-mediated conditional loss of Dicer results in malformation of the midbrain and cerebellum and failure of neural crest and dopaminergic differentiation in mice. Journal of molecular cell biology, 2(3), 152-163.
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Shimizu, A. (2008). Underwater Exercise Improves Cerebellar Ataxia in a Patient with Spinocerebellar Degeneration (A case report). The Journal of the Japanese Society of Balneology, Climatology and Physical Medicine, 71(4), 203-210.
Van der Geest, J. N., Lagers-van Haselen, G. C., Van Hagen, J. M., Govaerts, L. C. P., De Coo, I. F. M., De Zeeuw, C. I., & Frens, M. A. (2004). Saccade dysmetria in Williams–Beuren syndrome. Neuropsychologia, 42(5), 569-576.
Rasotto, C., Bergamin, M., Simonetti, A., Maso, S., Bartolucci, G. B., Ermolao, A., & Zaccaria, M. (2015). Tailored exercise program reduces symptoms of upper limb work-related musculoskeletal disorders in a group of metalworkers: A randomized controlled trial. Manual therapy, 20(1), 56-62.