Dysdiadochokinesia

Dysdiadochokinesia (pronounced “dis-dia-ah-duh-kow-kuh-nee-zhuh”) is difficulty making fast, alternating movements. It usually affects the muscles in your arms and legs and the muscles that help you speak. It basically means that there’s a malfunction in a part of your nervous system that controls coordination, rather than in a part that controls strength.

You may have trouble with:

• Balancing and walking
• Finger or foot tapping
• Opening and closing your fist
• Changing a lightbulb
• Articulating your speech

It can be very frustrating to live with dysdiadochokinesia. It can make you feel like your movements are slow, awkward or clumsy. You may have accidents, falls or physical injuries more often. Your words may be choppy or sound like a stutter. You might fumble over alliteration like, “p...p...picked p…p…pickled p…p…peppers.”

Treatment options are available to help you manage this symptom. A healthcare provider will diagnose it and determine the underlying cause. It’s usually a condition that targets the cerebellum in your brain.

What causes dysdiadochokinesia?

Dysdiadochokinesia happens when your cerebellum isn’t working as expected. The cerebellum is part of your brain. It’s in the lower back of your head near your brainstem. Damage to it affects your ability to coordinate your muscle movements and balance.

What conditions cause dysdiadochokinesia?

Damage or problems with how your cerebellum works can happen with conditions like:

• Encephalitis
• Friedreich’s ataxia
• Hashimoto disease
• Huntington’s disease
• Intracranial hemorrhage
• Ischemic stroke
• Multiple sclerosis
• Parkinson’s disease
• Schizophrenia
• Substance use disorder or alcohol use disorder
• Traumatic brain injury
• Vitamin deficiency (B1/thiamine, B12 or E)

Medications can also cause dysdiadochokinesia as a side effect, like with barbiturates and sedatives.

How is dysdiadochokinesia treated?

Treatment for dysdiadochokinesia varies based on the cause. A healthcare provider will help manage the cause first. The following treatments may also help:

• Physical therapy
• Occupational therapy
• Speech therapy
• Following an exercise program

Your provider may also recommend making adjustments around your living space to prevent falls that could lead to injury. This could include securing rugs to the floor or removing any tripping hazards.

Dysdiadochokinesia exercises

Your healthcare provider may recommend starting an exercise program to strengthen affected muscle groups in your body. The following may help:

• Balancing exercises
• Cycling on a stationary bike
• Strength training
• Walking on a treadmill

Your exercise program is specific to you and your body’s needs. You may work with a physical therapist or personal trainer to learn these exercises. They can show you how to safely use exercise equipment. They can also guide you on how long to do each exercise and when to increase or change intensity levels.

What are the possible complications of not treating dysdiadochokinesia?

Without treatment, you may be more at risk of falls or injuries. Some everyday tasks, like turning a doorknob, may be more challenging to do. You may feel frustrated that you’re unable to speak fluently, which could prevent you from socializing, speaking up or asking questions. As a result, untreated dysdiadochokinesia can impact your physical and mental health.

Can dysdiadochokinesia be prevented?

There isn’t a known way to prevent dysdiadochokinesia. A healthcare provider can help you manage any underlying health conditions that may lead to this symptom to reduce your risk.

When should dysdiadochokinesia be treated by a healthcare provider?

Visit a healthcare provider if you notice changes in your movement and speech. You might feel that tasks that were easy for you to do are now very challenging. This may be a sign of an underlying condition that needs treatment. A provider can help you figure out what’s causing it.

What tests diagnose dysdiadochokinesia?

Your provider will perform a physical examination, neurological examination and testing to learn more about what’s causing this symptom. Testing varies based on what other symptoms you experience, but they could include:

• Imaging tests (CT scan or MRI)
• Blood tests
• Urinalysis
• Lumbar puncture
• Psychiatric evaluation

Your provider may ask you to make repeated movements, like tapping your fingers or moving your palm face up or face down quickly.

Another common test to assess dysdiadochokinesia is the Romberg test. During this test, you’ll stand with both feet together on the floor. Your provider will instruct you to hold your arms to your side or crossed in front of your chest. Your provider will ask you to keep your eyes open, then close them. They’ll observe how and if your balance changes.