302 Pathogenesis of cerebellar disease and gait disorders Flashcards
What are some causes of unsteadiness?
-Orthopaedic problems (musculo-skeletal)
-Cerebellar ataxia
-Vestibular ataxia
-Sensory Ataxia
-Extrapyramidal gait disturbances
-Pyramidal gait disturbances
-Lower motor neuron gait disturbances
-Myopathic Gait Disturbances
What are some Orthopaedic Gait Disorders?
Antalgic (avoiding pain)
Spinal deformity
-Kypho-scoliosis
-Leg deformity / hypermobility
Eg. Shorter Leg, Knee hyper-extension, Knee or hip joint fixation / contracture
What is ataxic gait?
Awkward, uncoordinated walking
Often a truncal tremor
What is Romberg’s Sign?
Ask patient to stand with their heels together, first with their eyes open and then closed
Postural swaying or loss of balance= positive
When eyes open or closed: cerebellar ataxia
Only when eyes closed: sensory ataxia
What is hemiplegic gait?
When the leg is held stiffly and abducted with each step and swung around to the ground in front, forming a semicircle
What is diplegic gait?
Involvement on both sides with spasticity in lower extremities worse than upper extremities
Caused by Cerebral Palsy and Spinal cord damage
What is the parkinsonian gait?
-Forward tilt of trunk
-Reduced arm swing
-Shuffling gait with short steps
-Rigidity and trembling
What is high-stepping gait?
A way of walking when you have a foot drop
What is Waddling (Trendelenburg) Gait?
When the pelvis droops to the unsupported side alternating with each step
Results from many things including reduced action of the gluteus Medius muscle
