Cerebellar Examination
Cerebellar signs localise: midline vermal lesions give a wide-based gait, hemisphere lesions push the patient toward the side of the lesion. This checklist covers the DANISH screen and tells you what each positive finding means.
Introduction
0/5Inspection
0/3Inspect for any walking aids, obvious limb weakness, facial asymmetry
Look for wide based gait (ataxia from midline vermal lesion), staggering to one side (unilateral cerebellar hemisphere lesion causes staggering to side of lesion)
Differentiates between cerebellar vs proprioceptive cause
Eyes
0/1Test in both horizontal and vertical planes. Note: nystagmus will be elicited in everyone at extremes of lateral gaze.
Speech
0/1Assess for dysarthria
Arms
0/4Can occur in acute cerebellar lesions due to hypotonia. Note: Also present in lesions affecting proprioception.
Patient should move index finger to touch their nose to your finger as quickly and accurately as possible. Assess both sides.
Patient should turn hand over on opposite palm as quickly as possible. Assess both sides.
Inability to stop may indicate cerebellar lesion. Note: Also present in lesions affecting proprioception.
Trunk
0/2Check while patient is sitting up
Legs (lower limbs)
0/3Assesses coordination
Assesses coordination
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