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Neurology Cerebellar & Motor Disorders Intermediate
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Cerebellar Lesion Localization: DANISH

D
A
N
I
S
H
Classic neurological physical examination signs indicating ipsilateral cerebellar hemisphere or vermis pathology.

Cerebellar lesions produce IPSILATERAL motor deficits because cerebellar output pathways to the cortex and red nucleus decussate twice before descending to peripheral motor neurons.

Systematic Breakdown

D

Dysdiadochokinesia / Dysmetria

Inability to perform rapid alternating movements (e.g. palm-patting); past-pointing on finger-to-nose testing.

A

Ataxia (Gait & Limb)

Broad-based, unsteady, staggering 'drunken' gait (truncal ataxia localized to the midline vermis).

N

Nystagmus

Coarse, gaze-evoked horizontal nystagmus beating most forcefully toward the side of the cerebellar lesion.

I

Intention Tremor

Crescendo tremor that worsens as the patient's finger approaches the target object (unlike resting tremor in Parkinson's).

S

Slurred / Staccato Speech

Scanning speech where syllables are separated, irregular, and irregularly emphasized.

H

Hypotonia / Heel-Shin Deficit

Decreased deep tendon muscle tone and impaired smooth heel-to-shin coordination.

High-Yield Clinical Pearls & Exam Tips
  • Midline Vermis lesions: Truncal ataxia, unsteadiness, fall backwards (frequently seen in chronic alcoholism).
  • Lateral Cerebellar Hemisphere lesions: Limb ataxia, dysmetria, intention tremor on the IPSILATERAL side.
Related Pharmaceuticals
Baclofen Clonazepam
Related Clinical Conditions
Cerebellar Stroke Multiple Sclerosis Alcoholic Cerebellar Degeneration
Authoritative Sources: Fuller's Neurological Examination Made Easy 6e · First Aid USMLE Step 1

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