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 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…
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…
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 presented with a few week history of progressive weakness affecting the four limbs associated with muscle pain. He found it increasingly difficult to lift up his arms to above his shoulder level and also to climb stairs. There was in addition unintentional weight loss of 20 pounds (baseline of 180 pounds) during the…
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…
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…