Gait disturbance resident survival guide
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo M.D.
Synonyms and Keywords: disequilibrium, ataxia, spasticity, paresis, hypokinesia, imbalance
Overview
Gait disturbance refers to an impaired sense or absence of balance or equilibrioception that primarily occurs during standing or walking and usually without any cephalic sensations like headache, nausea, and vomiting. It is one among the causes of dizziness and it is typically a more complex category with more continuous symptoms than the other causes of dizziness like presyncope and vertigo.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated.
Common Causes
Diagnosis
Shown below is an algorithm summarizing the diagnosis of Gait disturbance according to the American Academy of Neurology guidelines:[1]
| Gait disturbance | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| When? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Always with movement (may vary in severity) | Intermittently during movement (may vary in severity and frequency) | Continuous and intermittent disturbances are present at least once | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Continuous | Episodic | Mixed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Transient inability to create effective stepping? | Unintentional increase in speed, usually with small steps? | Transient imbalance? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Freezing | Festination | Disequilibrium | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Disequilibrium and hypermetria of stance and gait? | Associated with increased postural tone? | Slow or small steps and/or slow or small postural? | Involuntary movements? | Associated with muscle weakness or paralysis? | Static or axial postural deformities? | Secondary to musculoskeletal or central pain? | Present at a higher level? | Difficult to classify the continuous nature of the gait disturbance? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Ataxic | Spastic | Bradykinetic/hypokinetic | Dyskinetic/Choreic/Dystonic | Paretic | Trunkal disturbance | Antalgic | Frontal disturbance | Undetermined | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Treatment
Shown below is an algorithm summarizing the treatment of [[disease name]] according to the [...] guidelines.
Do's
- The content in this section is in bullet points.
Don'ts
- The content in this section is in bullet points.
References
- ↑ Giladi N, Horak FB, Hausdorff JM (September 2013). "Classification of gait disturbances: distinguishing between continuous and episodic changes". Mov Disord. 28 (11): 1469–73. doi:10.1002/mds.25672. PMC 3859887. PMID 24132835.