Signs
 

Heel-to-Shin Test

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Overview

  • If the motor and sensory modalities are intact, inability to perform the heel-to-shin test smoothly is suggestive of ipsilateral cerebellar disease.
  • Patients may also be unable to perform this test accurately if they have significant proximal weakness.
    • How to Perform

    • With the patient supine, ask them to place their left heel onto their right shin just below the knee. Ask them to slowly and accurately run their heel down the length of the shin to the top of the foot.
  • Ask the patient to repeat this several times, and then perform the same test on the other side.
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