As one can appreciate in this video, this middle-aged man has right-sided intention tremor. The right index finger shows exaggerated tremor when approaching the target, i.e. his nose and physician’s finger. Please note that the examiner should place his finger at around one arm’s length from the patient. This is so that the patient could fully extend his upper limb in order to accurately elicit the clinical sign.
This patient did not have any recent ocular symptoms but was noted to have significant right eye ophthalmoplegia during examination, whilst the left eye movements were completely normal. There was no double vision upon testing. Whilst one would need to consider a combined third, fourth and sixth nerve palsy in a patient with unilateral opthalmoplegia,…
The patients shown in the these three videos all have idiopathic Parkinson’s disease. There is a typical resting tremor that involves the upper and lower limbs in the first patient, and only the upper limbs in the second and third patient. In all three patients, the right side is more severely affected. This is often the…
This patient complained of on and off tingling sensation over the lateral 3 ½ fingers of the right hand. There was wasting of the thenar muscles as noted in this photo. Further testing showed that the thumb abduction and opposition was weak. Tinel’s sign and Phalen’s test was positive. A nerve conduction study was performed,…
This is a patient with neurofibromatosis type 1, an autosomal dominant neuro-cutaneous disorder. In the first two photos (Figures 1 and 2), multiple neurofibromasas well as café-au-lait spots are present on the trunk and upper limbs. In the third and forth photo (Figures 3 and 4), freckling can be seen at the axillary and inguinal…
In this video, the patient exhibits a positive heel-shin test on the right side. Compared to the left (normal) side, the right lower limb is seen to be rather clumsy. The heel-shin test is a test to screen for ipsilateral cerebellar function. Once again, clear instructions are required for this test, and you could see…
These two photos (Figures 1 and 2) show wasting of the left small hand muscles including the interosseous muscles, 3rd and 4th lumbricals and hypothenar muscles. The picture also shows an ulnar claw hand in which there is extension of the metacarpophalangeal joints and flexion of the proximal and distal interphalangeal joints of the 4th…