The gait is wide-based and the patient requires assistance from the physician for stabilization. The patient cannot turn within one or two steps but requires multiple steps. The physician then asks the patient to perform tandem-walking at the end of the video but the patient is unable to do so due to severe instability. The patient exhibits ataxia which could be due to a cerebellar problem or deficits in proprioception.
The patients in these two photos show the classical signs of Horner’s syndrome. In the first photo (Figure 1), there is left-sided partial ptosis, miosis and anhidrosis. Whilst in the second photo (Figure 2), there is right-sided ptosis and miosis. Horner’s syndrome is caused by a lesion affecting the sympathetic pathway. This pathway starts as…
In this video, the presence of ankle clonus is being tested. Clonus is defined as a series of rhythmic, involuntary muscular contractions induced by sudden passive stretching of a muscle or tendon. To test for ankle clonus, the leg and foot should be relaxed and the knee and ankle placed in a slight flexed position….
This is a video from a middle-aged man with myotonic dystrophy type 1, an autosomal dominant multi-systemic disorder that not only affects the muscles, but also causes other problems such as cataracts, arrhythmias and diabetes mellitus. The video shown here is typical of myotonia which can be seen in these patients. The tone is usually…
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,…
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,…
Intention tremor can be elicited by the finger-nose test. In normal patients, the movements between the physician’s finger and patient’s nose should be smooth, but adjustment is allowed according to the patient’s upper limb power. This man has intention tremor and impaired finger-nose test on the right side, whilst the left side is normal. Discussion on intention…