Cere b e l l a r Exa m i nation
Can the patient rapidly and alternately pat the pal m of the hand and the
dorsum of the hand on a surface? This is the rapid alternating movement test,
which assesses the cerebellum 's ability to coordinate agonists and antagonists.
Impairment of this is termed dysdiadochokinesis.
An intention tremor is a tremor that worsens with motion toward a particular
poi nt. It is checked for by havi ng the patient ra pidly alternate pointing (and
touching) the examiner's outstretched finger and the patient's nose (finger-nosefi
nger test).
The heel-knee-shin test involves touching one heel to the opposite knee and
smoothly moving the heel down the opposite shin to the ankle and back up to
the knee. Normally this is a steady movement, but patients with ataxia wobble
the moving leg from side to side.
An inability to perform any of these tests (in the absence of significant motor
weakness) suggests ipsilateral cerebellar dysfunction.