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🧠 Unilateral cerebellar syndrome is not a diagnosis.
It is a localization clue.

When you find ipsilateral:
🔹 Ataxia
🔹 Intention tremor
🔹 Dysdiadochokinesia
🔹 Nystagmus
🔹 Hypotonia
🔹 Past pointing
🔹 Broad-based gait

…always think about the site of lesion.

📍 The lesion may involve:
▪️ Cerebellar hemisphere
▪️ Cerebellar peduncle
▪️ CP angle
▪️ Brainstem connections

⚠️ Common causes include:
▪️ CP angle tumors (especially Vestibular Schwannoma)
▪️ Cerebellar stroke or hemorrhage
▪️ Other space occupying lesion- Tuberculoma, abscess, tumor
▪️ Demyelination - Multiple sclerosis

🚨 A CP angle lesion becomes especially important when cerebellar signs coexist with cranial nerve involvement, particularly CN V, VII & VIII.

📌 Note:
▫️ Do not forget to do RINNE and WEBER test if you find 8th CN involvement

▫️ Check for BULBAR MUSCLE weakness to exclude LATERAL MEDULLARY SYNDROME

🎥 In this video, we will clinically localize unilateral cerebellar syndrome and understand how to approach it bedside.

🎯 In this video also we demonstrated the approach of prompt:
“EXAMINE THE PATIENT NEUROLOGICALLY”

✅ This video was taken with permission for academic purpose.

Right eye: complete ptosis + completely restriction of movement.

This is a classic example of combined involvement of Oculomotor nerve(III) , Trochlear nerve(IV) and Abducens nerve(VI).

Key question: Where is the lesion?

👉 Cavernous sinus
👉 Superior orbital fissure / Orbital apex

Now push further:
• Is vision affected? → think orbital apex (optic nerve involvement)
• Is there pain/proptosis? → think cavernous sinus pathology

Always localize before you diagnose.

Note: This video was taken with permission for academic purpose.

Look closely at this.

Patient presents with clumsiness of hands — a subtle but important red flag.

On eliciting the supinator jerk:
Instead of normal brachioradialis (supinator) contraction, you see finger flexion.

This paradoxical response is called Inverted Supinator Jerk.

👉 A classic, high-yield clinical sign of cervical myelopathy
👉 Typically indicates a lesion above C5–C6

Small sign.
Big localization clue.

This is why clinical examination still wins.

Most people miss this—and it costs diagnoses.

That side-to-side walk? Waddling gait.

That “climbing up the thighs”? Gowers’ sign.

👉 Together = proximal muscle weakness

Can you name the causes? 👇
Check comments

Remember the signs of CHOREA

*Milk maid's Grip
*Spoon sign
*Jack in box Tongue
*Pronator sign/ Pyramid Sign

This attached video shows the neurological examination procedures and signs of a patient of chorea.

Another important thing worth mentioning is that the sustained or patterned abnormal posturing of the hands suggests dystonia.

Note: Video was taken with permission of the patient.

Courtesy - Dr. Md. Omar Faruk Shawon