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An Abnormal Finger–Nose–Finger Examination

Published:September 22, 2021DOI:https://doi.org/10.1016/j.jpeds.2021.09.022
      A previously healthy 6-year-old girl presented with a complaint of intermittent “fuzzy” vision provoked by reading. There was no history of eye pain, redness, or tearing; headache; ataxia; weakness; or vomiting. Examination revealed decreased visual acuity (best estimate 20/50 both eyes with variable performance), irregular responses to questions about the number of objects being displayed, and an abnormal finger–nose–finger test. The patient accurately touched the first stationary finger target, but as the examiner’s finger moved, she consistently pointed to the previous location where the finger had been and then traced the path to the current location of the finger (Figure and Video [available at www.jpeds.com]). She described seeing a finger in both locations with a blur between, consistent with illusory palinopsia. The remainder of her examination, including neurologic examination, was normal.
      Figure thumbnail gr1
      FigureDuring finger–nose–finger testing, the patient consistently pointed to the previous location where the examiner's finger had been and then traced the path the examiner's finger had taken to its current location.
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