There’s nothing quite like examining a cerebellar syndrome patient on a busy ward round when you’re half-caffeinated and your SHO looks more uncoordinated than the patient. Cerebellar signs are subtle, occasionally theatrical, and easily confused with other neuro signs unless you’re well-prepped.
That’s where the trusty mnemonic DANISH comes in.
Yes, DANISH – not the breakfast pastry, but equally essential if you want to avoid saying “gait abnormality” and hoping nobody asks for details. 😅
🧠 Cerebellar signs Mnemonic: “D.A.N.I.S.H”
| Letter | Sign | Explanation |
|---|---|---|
| D | Dysdiadochokinesia | Inability to perform rapid alternating movements (clap-tap test gets awkward) |
| A | Ataxia | Gait or limb incoordination—think patient walking like they’ve just left a wedding 🍷 |
| N | Nystagmus | Rhythmic oscillation of the eyes—horizontal or vertical, depending on lesion |
| I | Intention tremor | Tremor worsens as target is approached (usually ~3 Hz) |
| S | Speech (Scanning/Staccato) | Slurred, broken speech—like Siri learning Balochi |
| H | Hypotonia | Decreased tone, often mistaken for laziness by untrained examiners 😆 |
🩺 A Cerebellar Case from Chagai, Balochistan
Last year, we had a young patient from Chagai who presented to the CCU after a fall. His gait looked like mine after being post-call for 36 hours. On exam, he had bilateral dysdiadochokinesia, scanning speech, and a right-sided intention tremor that made the finger-nose test look like a game of “guess where my hand is.”
MRI confirmed a midline cerebellar lesion. The DANISH mnemonic literally saved the day during our morning discussion with Dr. Basit Khan—who still insists that cerebellar signs are “just neurological poetry.” 🎭
