Gait Flashcards
Dyskinesia
Abnormal uncontrolled involuntary movement
Hyperkinesis
Increased movements, abnormal, involuntary
Increased by stress/anxiety; decreased with sleep
Hypokinesia
Decreased movements
Diseases with hypokinesia
Parkinsons and depression
S/s with Parkinson’s
Bradycardia Mask-like expression/stare Decreased blinking Soft speech Rigidity Loss of swinging arms while walking
Physiological tremor
Benign
Affects fingers/hands
With rest and activity
Accentuated with anxiety and activity
Myoclonic jerks/myoclonus
Quick involuntary muscle jerks
“Sleep starts” or hiccups
Occur in healthy people but frequently seen in epileptics prior to seizure
Quick involuntary muscle jerks
“Sleep starts” or hiccups
Occur in healthy people but frequently seen in epileptics prior to seizure
Myoclonic jerks/myoclonus
Benign fasiculations
Fine rapid flickering twitching movements
Due to contraction of a bundle of muscle fibers
Ex: twitching eyelid
Motor neuron disease
Examples of benign fasiculations
Twitching eyelid
What causes benign fasiculations
Fatigue Cold Caffeine Motor neuron disease: ALS Radiculopathy, peripheral neuropathy, anterior horn cell LMNL
Emotional tremor aka?
Essential tremor
Emotional tremor
Rapid tremor of low amplitude that worsens with emotional stress
Familial, senile
Parkinsonian tremor
Pill-rolling at rest aka resting tremor
Basal ganglion lesion
Lesion where with parkinsonian tremor
Tremor at rest
Lesion at basal ganglion
Intention tremor lesion where
Cerebellum
Intention tremor seen with
Cerebellum pathology
Ex: MS
Postural tremor
During fixed posture
Non-tremorous hyperkinesia or chorea
Involuntary, irregular hyperkinesias
Huntington’s
Non-tremorour hyperkinesia associated with what disease
Huntington’s
Athetosis
Slow, writhing/squirming movements of fingers and extremities
Congential
Injury to basal ganglia
Cerebral palsy
Athetosis seen with what disease
Basal ganglia injury
Cerebral palsy
Dystopia
Spontaneous involuntary sustained muscle contractions
Hemiballismus
Dramatic neurologic syndrome with wild violent movement of half of body
Due to infarction or hemorrhage
What causes hemiballismus
Infarction or hemorrhage
Tics
Irregular repetitive movements of face/tongue
Ex: blinking
Associated with emotional stress
Akathisia
Inner restlessness and urge to move
Remain in constant motion
Due to treatment with dopamine blocking agents
What is seen with dopamine blocking agents
Akathisia
Tardive dyskinesias (TD)
Involuntary movement of face, mouth, tongue and limbs
Side effect of antipsychotic/neuroleptic medications
What is a side effect of antipsychotic/neuroleptic medications
Tardive dyskinesia
What is first compensation in most gait disorders
Spreading feet father apart
Tabetic aka sensory ataxic gait
Dorsal column disease
Loss of proprioceptive sense in extremities
Walk with wide base, slap feet
High steps, throw foot out, slams it to flood
***worse with dark/eyes closed
Sensory ataxic gait anatomy
Dorsal columns
Recall open/closed= cerebellum., closed DC
Hemiplegic gait
Corticospinal lesion
Hold arms tight to side and drags/shuffles foot
Tilt pelvis upward on involved side to lift toe and may swing extremity (circumductoin)
Corticospinal lesion
Hold arms tight to side and drags/shuffles foot
Tilt pelvis upward on involved side to lift toe and may swing extremity (circumductoin)
Hemiplegic gait
Anatomy in hemiplegic gait
Corticospinal pathway MC with stroke!!!!
Hemiplegic gait seen in what patients post?
Stroke
Scissoring gait seen in who
Cerebral palsy
MS
Scissoring gait
Basically bilateral hemiplegic gait
Compensatory sway, knees cross in front, narrow base, shuffling
Cerebellum ataxic/drunken/staggering
Drunk
common in MS, cerebellum degeneration, cerebellum tumors, stroke
Waddling aka myopathy gait
Weakness of pelvic girdle muscles causes drop to unsupported leg.
Hyperlordotic, swayback, pot belly
Muscular dystrophy
Disease seen with waddling/myopathy gait
Muscular dystrophy
Stoppage gate
Seen with patients with foot drop
Causes of unilateral steppage gait? Bilateral?
Unilateral: peroneal/fibulae nerve palsy and L5 radiculopathy
Bilateral: ALS, Charcot-Marie tooth diease, severe peripheral neuropathies
Propulsion/festinating
Parkinsons
Difficulty walking may be earliest s/s of Parkinsons
Hysterical gait
Variet of bizarre gaits seen with conversion reaction
***ability to use the limb during emergencies
Astasia-Abasia
Motor in coordination and inability to stand or walk but have normal ability to move legs when lying or sitting
Limping/antalgic
Disordered due to paim
