Abstract
A 61-year-old man, six weeks following an orthotopic cardiac transplant for hypertrophic cardiomyopathy, presented with dysarthria, ataxia and confusion. On examination he was found to be dysarthric and to display dysmetria and dyssynergia on finger-nose testing, and markedly hypometric saccades to target. Gross truncal ataxia was present in the seated position and there was impairment of the visually enhanced vestibulo-ocular reflex. Assessment of power was normal throughout and sensory modalities including pin prick and vibration sense perception were intact.
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