Ataxia physical examination

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Mental status examination

Abnormalities in higher cortical functions like executive functions, spatial orientation, motor memory, language functions, and emotional recognition and production

• Impairment of consciousness,
• Visual changes,
• Trouble speaking and swallowing,
• Focal sensory loss or weakness,
• Vertigo,
• Slow and abnormal movements,
• Cognitive impairment, and
• Behavior changes.

Cerebellar signs

The gait is affected in almost all patients. Patients cannot stand with their feet together. Tests like tandem stance or walking can be used. Gait is wide-based. Also, we can see impaired cerebellar functions, like limb dysmetria, intention tremors, along with loss of tone, as well as dysarthria and nystagmus.

Strength

• Symmetric proximal muscle weakness has been seen. Distal muscle weakness can also be present, which suggests generalized neuropathy.
• Gait dysfunction may also suggest muscle weakness rather than ataxia.

Extrapyramidal system

• Rigidity with slowed movements
• Slowed or delayed postural corrections
• Dystonia or limitations of vertical gaze

References

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