Which of the following is NOT a typical PT sign in Chiari II malformation?

• A. Seizures
• B. Fine motor incoordination and UE weakness
• C. Balance issues
• D. Hypotonia

Answer: (B)

In Chiari II malformation, motor problems tend to reflect the level of spinal involvement, with greatest impact on the legs and trunk rather than the hands and upper limbs. This pattern comes from the underlying spinal dysraphism and the way it disrupts motor pathways lower in the neuraxis. So, upper-extremity fine motor incoordination and weakness are not typical PT signs because the neural disruption is usually below the cervical level, sparing the arms compared with the lower body.

You would more commonly expect signs like hypotonia and balance issues from trunk control difficulties, which affect posture and gait. Seizures aren’t a direct PT sign either—they’re neurological events that can occur with hydrocephalus or cortical malformations, but they don’t reflect the motor pattern PTs routinely assess.