Muscle Incoordination When Rotating the Wrist and Touching the Palms

CLINICAL DIAGNOSTIC MANUAL

Muscle incoordination when rotating the wrist and touching the palms, also known as dysmetria or dysdiadochokinesia, is a neuromuscular dysfunction that can result from various pathologies.

This condition is characterised by difficulty performing rapid and precise alternating movements, which can interfere with daily activities requiring manual dexterity. The underlying cause of this incoordination can involve upper or lower motor neurons, cerebellar pathways, or proprioception, the body’s ability to perceive its position in space.

Condition	Clinical Symptoms and Signs	Suspected Diagnosis	Confirmatory Diagnosis
Upper motor neuron paresis	Spastic hypertonia, weakness, exaggerated reflexes, Babinski sign, difficulty with precise movements	Clinical history, neurological exam	Brain and spinal MRI, nerve conduction studies
Lower motor neuron paresis	Weakness, muscle atrophy, fasciculations, hypotonia, diminished reflexes	Clinical history, neurological exam	EMG, nerve conduction studies
Ipsilateral cerebellar lesion	Intention tremor, dysmetria, dysdiadochokinesia, ataxia, nystagmus, ipsilateral incoordination	Clinical history, neurological exam	Brain MRI, cerebellar coordination tests
Loss of proprioception	Difficulty perceiving joint position, sensory ataxia, clumsy movements	Clinical history, neurological exam, signs of sensory ataxia	Nerve conduction studies, brain and spinal MRI