Gait and Cerebellar Dysfunction

Question 1

What can cause a person to have an abnormal stance prior to walking?

Answer 1

• DCP lesion

- Cerebellar lesion

Question 2

Broad-based Ataxic Gait

• What is it?
• What is it seen in?

Answer 2

Feet are spread wide apart with a unsteady gait.

• Seen with lesions of DCP or sensory nerves or cerebellar lesions

Question 3

Hemiplegic Gait

• What is it?
• What is it seen in?

Answer 3

Lower limb is stiffly extended and swung out and circumducted while upper limb is flexed at the elbow and wrist

• Seen in stroke pts

Question 4

Tabetic Gait

• What is it?
• What is it seen in?

Answer 4

Foot slapping gait to compensate for impaired sensation.

• Seen in neurosyphilis or severe neuropathy

Question 5

Steppage Gait

• What is it?
• What is it seen in?

Answer 5

Foot drop is found so the hip flexes higher to prevent tripping over the foot.

• Seen in peroneal nerve lesions that lead to foot drop

Question 6

Waddling Gait

• What is it?
• What is it seen in?

Answer 6

Weak pelvic/hip muscles cannot support the body on one leg so swaying occurs in the opposite direction to the raised foot to compensate.

• Seen in myopathy

Question 7

Scissors Gait

• What is it?
• What is it seen in?

Answer 7

Tightness and spasms in adductor muscles of thighs forces the knees together when walking.

• Due to CST lesions as in cerebral palsy/MS that lead to spastic paraparesis

Question 8

Parkinsonian Gait

• What is it?
• What is it seen in?

Answer 8

Slow, shuffling gait with hunched forward posture.

• Seen in Parkinson’s disease

Question 9

What are pupils that are unreactive to light but constrict with the near reflex indicative of?

Answer 9

Argyll-Robertson pupils - indicative of neurosyphilis

Question 10

Rebound

Answer 10

Imbalance of agonist and antagonist muscles that leads to the sudden release of
contracted biceps causes striking the face; triceps
does not “check” this action anymore

Question 11

Hemispheral Syndrome of Cerebellum

Answer 11

Predominantly affects ipsilateral limbs ipsilaterally (kinetic tremor, limb dysmetria, rebound phenomenon)

Question 12

Vermian Syndrome of Cerebellum

Answer 12

Predominantly affects the trunk (truncal unsteadiness with

standing or walking, tremor, postural impairment, gait ataxia)

Question 13

Alcoholic Cerebellar Degeneration

Answer 13

Atrophy of anterior-superior vermis with gait ataxia and lower limb dysmetria.

Question 14

Hemiballismus

Answer 14

Rapid, violent, flinging movements of proximal upper and lower limbs on one side due to a lesion of the contralateral subthalamic nucleus;

Question 15

Dystonia

Answer 15

Continual or sustained painful contraction of muscles, causing
turning and spasms of the limbs or neck, with fixed, unnatural postures.

Question 16

Tic

Answer 16

Brief, semipurposeful, stereotyped, repetitive contractions of groups of muscles

Question 17

Myoclonus

Answer 17

Rapid, shocklike movements of the limbs or body, usually

bilateral, but often asynchronous - due to diffuse encephalopathies

Question 18

Treatments for Essential Tremor

Answer 18

• Beta blockers

- Barbiturates

Question 19

Treatments for Resting Tremor

Answer 19

• Anticholinergics
• L-DOPA
• DOPA agonists

Question 20

Treatments for Choreoathetosis/Hemiballismus

Answer 20

DOPA Antagonists

Question 21

Treatments for Dystonia

Answer 21

• Anticholinergics
• Benzodiazepines
• Botulinum Injections