Anatomy clinical correlates Quiz: Ace Your Exams

A 49-year-old man is evaluated at the office for gait disturbance. A social worker referred the patient due to frequent falls. Past medical history includes alcoholic fatty liver disease. The patient has smoked one pack of cigarettes daily for 20 years and drinks approximately 60 oz of alcohol every week. Vitals are within normal limits. The patient is cooperative and oriented to person, place, and time. Physical examination demonstrates mild gaze-evoked horizontal nystagmus. The patient has a wide-based gait. Tapping the patellar tendons elicits persistent, slow, back and forth swinging of the legs.  Finger-to-nose testing shows no abnormalities. Romberg sign is absent. Muscle strength is 5/5 in all extremities. Sensation is intact in the upper and lower extremities bilaterally. Standardized assessment of cognitive function shows no abnormalities. Which of the following additional features is likely to be observed in this patient?