Last Updated on August 19, 2026
Steps of Examination
a. Head / Face
• Look for
nystagmus
• Usually horizontal nystagmus • Cerebellar speech: jerky, explosive and loud, with irregular separation of syllables
• Amplitude of nystagmus increases on looking towards the side of lesion
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OTHERS:
•
Speech
• Not frequently done; can be performed if patient is easily cooperative
b. Upper limbs
• Shake hand to test
tone
• Hypotonia due to loss of facilitatory influence on spinal motor neurons • Upward arm drift due to hypotonia of agonist muscle • Dysdiadochokinesia if patient is unable to perform the test smoothly • Dysdiadochokinesia if the movement is slow and clumsy
• Ask patient to lift arms (forward), look for
arm drift
•
Finger-nose test
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Look for
(i) Intention tremor, i.e. tremor increasing when target is approached, but no tremor at rest
(ii) Past-pointing, i.e. patient’s finger overshoots the target (your finger) towards the side of cerebellar abnormality
• Test for
rapidly alternating movements
c. Lower limbs
• Test
tone
• Hypotonia due to loss of facilitatory influence on spinal motor neurons Patient staggers towards affected side in unilateral cerebellar lesion
• Heel-shin-test: Ask patient to slide the heel down slowly on each side of the lower limbs for several cycle
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OTHERS
• Test
gait