Dysdiadochokinesia (DDK)


hand movement


Dysdiadochokinesia (DDK) stems from changes to the cerebellum and is a form of ataxia that leads to the loss of coordination of speech and movement. The signs of dysdiadochokinesia include:

  • changes in balance and gait
  • slow, awkward or rigid movements
  • declining coordination of the arms, hands, or legs
  • inarticulate or incomprehensible speech patterns
  • impairment of directional movement

For example, dysdiadochokinesia may cause a person to have difficulty installing or removing a light bulb, turning a door knob, or any type of quick movement that requires a rapid directional change will become difficult to complete. They may also have a hard time quickly repeating one to three syllables in a row.

dysdiadochokinesia and cerebellar ataxia in Superficial Siderosis patients is challenging to treat. Physical, speech, and occupational therapy plans that include strength training, balance exercises, treadmill, stationary cycling may help improve day-to-day function. An evaluation of the patient’s home environment should be conducted to identify potentially unsafe areas and the use of assistive medical devices should be encouraged.

Your neurologist can perform simple in-office tests to evaluate dysdiadochokinesia.

Rapidly Alternating Movement Evaluation

You’ll hold the palm of one hand on a flat surface (often the upper thigh), and then continuously flip the hand palm side up, then back to palm side down as fast as possible.

Point-To-Point Movement Evaluation

You’ll be asked to touch your nose and then, using the same finger and as quickly as possible, touch the outstretched finger of the person doing the test.

Heel-Shin Test

You’ll place one heel on one shin just below the knee, and then slide the heel down the shin to the foot. You should aim for rapid, coordinated movements.

Romberg Test

You’ll stand still with your heels together and your eyes closed. If you lose your balance in this position, you may have some form of DDK.

Gait Test

You’ll be asked to first walk with your normal stride and then walk heel to toe.




Updated: November 2, 2020

Sources: Superficial siderosis is a rare neurologic disease characterized by progressive sensorineural hearing loss, cerebellar ataxia, pyramidal signs, and neuroimaging findings revealing hemosiderin deposits in the spinal and cranial leptomeninges and subpial layer. The disease progresses slowly, and patients may present with mild cognitive impairment, nystagmus, dysmetria, spasticity, dysdiadochokinesia, dysarthria, hyperreflexia, and Babinski signs. Additional features reported include dementia, urinary incontinence, anosmia, ageusia, and anisocoria. Superficial siderosis MedGen UID: 831707 •Concept ID: CN226971 •Finding Orphanet: ORPHA247245
Living With SuperficialSiderosis Website PubMed Reference Library 

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