MEDizzy - A 65-year-old diabetic man has a history of a cerebellar

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The Neurological Examination and Diagnostic Tests

A 65-year-old diabetic man has a history of a cerebellar stroke. The stroke occurred 5 years ago, and he says that he has now fully recovered. He cannot recall the symptoms, but his medical records state that he presented with left-sided dysdiadochokinesia. Which of the following was most likely impaired?

ExplanationC. Dysdiadochokinesia is usually apparent with cerebellar damage. It is most evident when strength and sensation are intact. Alternately tapping one side of the hand and then the other, or tapping the heel and then alternating with the toe of the foot, is the test usually employed to check this aspect of coordination. Multiple sclerosis in adults and cerebellar tumors in children are two of many causes of problems with this part of the neurologic examination. Focal lesions in the nervous system may produce highly asymmetric dysdiadochokinesia. A variety of movement disorders, such as Parkinsonism and choreoathetosis, may interfere with rapid alternating movements and give the false impression that the patient has a lesion in systems solely responsible for coordination.