Professor Shu Leong Ho, Dr Gary Lau, Dr Richard Chang, Dr Sonny Hon and Dr Joseph Kwan
These two videos are from a middle-aged man presenting with progressive bilateral lower limb and right upper limb weakness for few months. In the first video, there are prominent fasciculations over the entire right upper limb. Whilst in the second video, fasciculations can also be noted over both lower limbs, but more prominent on the…
The knee-jerk, ankle-jerk and plantar reflexes are being examined in this patient. There is a slight down-going plantar reflex on the right side. Otherwise, all other reflexes are absent. Discussion of the sign Areflexia may indicate deficits in the reflex loop. This may be due to a lesion involving the sensory neuron or the lower motor…
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…
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…
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…