The treatment of two patients with cerebellar disfunction is described
. One patient was a 36-year-old woman with a 7-month history of dizzin
ess and unsteadiness following surgical resection of a recurrent piloc
ystic astrocytoma located in the cerebellar vermis. The other patient
was a 48-year-old man with cerebrotendinous xanthamatosis (CTX) and di
ffuse cerebellar atrophy, and a 10-year history of progressive gait an
d balance difficulties. Each patient was treated with a 6-week course
of physical therapy that emphasized tile practice of activities that c
hallenged stability. The patient with the cerebellar tumor resection a
lso performed eve-head coordination exercises. Each patient had weekly
therapy and performed selected balance retraining exercises oil a dai
ly basis at home. Measurements taken before and after treatment for ea
ch patient included self-perception of symptoms, clinical balance test
s, and stability during selected standing and gait activities; for the
patient with the cerebellar tumor resection, vestibular function test
s and posturography were also performed. Both patients reported improv
ements in symptoms and demonstrated similar improvements on several ki
nematic indicators of stability during gait. The patient with the cere
bellar tumor resection improved on posturography following treatment,
whereas the patient with CTS improved on clinical balance tests. This
case report describes two individualized treatment programs and docume
nts functional improvements in two patients with different etiologies,
durations, and clinical presentations of cerebellar dysfunction. The
outcomes suggest that patients with cerebellar lesions, acute or chron
ic, may be able to learn to improve their postural stability.