Upper Limb Neurological OSCE Examination Quiz

A right-handed woman has progressive clumsiness of the hands. On examining the upper limbs you find wasting and fasciculations in the small hand muscles, reduced tone, weak finger abduction and thumb opposition, and reduced biceps and triceps reflexes. Sensation and coordination are normal. Which is the single best way to finish and present the examination?

On the finger-to-nose test, which finding most directly suggests a cerebellar lesion?

Before an upper limb neurological examination, a 32-year-old woman holds both hands outstretched. When she closes her eyes, her fingers develop slow, writhing movements that are less obvious when her eyes are open. Which interpretation best explains this finding?