Alt + Ctrl keys for nudge quit working

Rhino - Version 5 SR12 64-bit. The Alt key works fine but when I add the Ctrl key nothing happens. The command line shows no response. The Ctrl key works fine in other commands in Rhino. I use it frequently for keyboard shortcuts. Settings seem correct but it just isn’t working.

TIA,
Robb

Have a look at the controls and settings in Rhino Options > Modeling Aids > Nudge.
Perhaps your distance to be nudge is too small to be noticed.
It does report the distance on the Command line when you Nudge.