Case 2 – Ataxia

Tim Milligan Neurology

You are seeing Mrs. Salamanca, a 45 year old female, in your outpatient clinic. She’s been complaining of unsteadiness when she walks. Please perform a complete examination of her coordination.

Physical Examination

Gait

  • Asks patient to walk to assess gait
  • Assesses toe walking
  • Assesses heel walking
  • Assesses tandem gait
  • Comments on wide, ataxic gait with unequal steps

Balance

  • Performs Rhomberg Test

Motor examination

  • Gross: Performs heel to shin test
  • Gross: Performs finger to nose test
  • Fine: Alternating fingers to thumb
  • Fine: Alternating palm to hand
  • Assesses for intention tremor
  • Assesses for dysarthria
  • Assesses for nystagmus
Case 2 – Ataxia