EpistemisAdiadochokinesia
Specialty: Neurology.
Why it occurs
- Acute cerebellar stroke
- Multiple sclerosis with involvement of the afferent or efferent cerebellar pathways
- Multiple system atrophy syndrome cerebellar type (MSA-C)
- Intoxication by benzodiazepines, alcohol, barbiturates or antiepileptics
- Posterior fossa tumors (medulloblastoma, cerebellar astrocytoma)
Initial workup
Test of rapid pronosupination of the hands on the thighs or alternating tapping with the thumb on the index finger; brain magnetic resonance imaging directed to the posterior fossa; screening for blood levels of anticonvulsant drugs; lumbar puncture with cytological study and oligoclonal bands if multiple sclerosis is suspected.
red flags
Rapidly progressive adiadochokinesia associated with lower cranial nerve palsies (dysphagia, dysphonia, deviation of the uvula), diplopia, facial paralysis or alteration of consciousness, indicating involvement of the brainstem or posterior fossa that requires urgent neurological intervention.
Standard management
- Adjustment or withdrawal of central nervous system depressant drugs or anticonvulsants with therapeutic ranges exceeded
- Neurological physiotherapy focused on psychomotor skills and fine motor reeducation.
Educational guidance for study. It is NOT a prescription recommendation. The actual choice depends on the cause, the patient, and current guidelines.
- Area
- Neurology
- Listed causes
- 5
- Treatment options
- 2