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Incoordination

Past-Pointing: Finger-Nose-Finger Test
Patient touches examiner’s* finger.
  • Patient touches his/her own nose.
Patient touches examiner’s* finger, again.
    • Past-pointing refers to when the patient cannot brake the movement and overshoots the examiner's finger.
Cerebellar Drift
  • With eyes closed, patient exhibits an upward drift with the arms outstretched.
  • “Spooned” hand posture: uneven interplay b/w agonists and antagonists.
  • Examiner lightly taps the outstretched arm to displace it downward.
    • Patient overshoots as places arm in its former position.
Finger Tapping Abnormalities
  • Patient taps the thumb and index finger, repetitively.
    • In cerebellar disease: the amplitude and rhythm vary.
    • In pyramidal disease: normal rhythm but slow and move in concert (failure to fractionalize).