Movement Disorders plus Gait exam (NOT ON EXAM)

Question 1

Extrapyramidal Signs: refera to ________, NOT paresis or sensory loss

Answer 1

abnormal movement, posture, or muscular tone

Question 2

what does a positive rebound test show

Answer 2

Increased range of movement with lack of normal recoil to original position, is seen in cerebellar disease

Question 3

what can cause pronator drift?

Answer 3

Pyramidal Tract Dysfunction
Cerebellar Dysfunction
Parietal Lobe Dysfunction

Question 4

what can cause a positive romberg?

Answer 4

Impaired Proprioception (DC/Spinal Cord)
Impaired Vestibular Function (fall toward lesion)
Impaired Cbl function (mainly vermis or vestibulocbl)

Question 5

describe a hemiparetic gait,

Answer 5

When walking, the patient will hold his or her arm to one side and drags his or her affected leg in a semicircle (circumduction) due to weakness of distal muscles (foot drop) and extensor hypertonia in lower limb.

Question 6

what causes a hemiparetic gait?

Answer 6

unilateral UMN injury (from a hemispheric stroke for example),

Question 7

describe a Diplegic gait.

involves spasticity in lower extremities worse than upper extremities. This gait is seen in

Answer 7

The patient walks with an abnormally narrow base, dragging both legs and scraping the toes.

There is also characteristic extreme tightness of hip adductors which can cause legs to cross the midline referred to as a scissoring gait.

Question 8

what causes a diplegic gait

Answer 8

bilateral periventricular lesions, such as those seen in cerebral palsy.

Question 9

describe a Neuropathic gait (Steppage Gait, Equine Gait) is

Answer 9

seen in patients with foot drop (weakness of foot dorsiflexion). The cause of this gait is due to an attempt to lift the leg high enough during walking so that the foot does not drag on the floor.

Question 10

what causes unilateral Neuropathic gait (Steppage Gait, Equine Gait) ?

Answer 10

peroneal nerve palsy and L5 radiculopathy

Question 11

what causes bilateral, Neuropathic gait (Steppage Gait, Equine Gait) ?

Answer 11

myotrophic lateral sclerosis,
Charcot-Marie-Tooth disease
other peripheral neuropathies including those associated with uncontrolled diabetes.

Question 12

describe a Myopathic Gait (Waddling Gait)

Answer 12

Hip girdle muscles are responsible for keeping the pelvis level when walking. If you have weakness on one side, this will lead to a drop in the pelvis on the contralateral side of the pelvis while walking (Trendelenburg sign).

With bilateral weakness > dropping of the pelvis on both sides > waddling.

Question 13

what cause sMyopathic Gait (Waddling Gait)

Answer 13

myopathies, such as muscular dystrophy.

Question 14

describe a Choreiform Gait (Hyperkinetic Gait)

This is also sometimes called a “dancing” or Prancing” gait.

Answer 14

The patient will display irregular, jerky, involuntary movements in all extremities. Walking may accentuate their baseline movement disorder.

Question 15

describe an Ataxic Gait is most commonly seen in cerebellar disease, Patients will not be able to walk from heel to toe or in a straight line. The gait of acute alcohol intoxication will resemble the gait of cerebellar disease. Patients with more truncal instability are more likely to have midline cerebellar disease at the vermis.

Answer 15

clumsy, staggering movements with a wide-based gait. While standing still, the patient’s body may swagger back and forth and from side to side, known as titubation

Question 16

describe an Ataxic Gait

Answer 16

clumsy, staggering movements with a wide-based gait. While standing still, the patient’s body may swagger back and forth and from side to side, known as titubation

Question 17

what causes an ataxic gait

Answer 17

cerebellar disease

Question 18

describe a Sensory Gait

Answer 18

patient will slam the foot hard onto the ground in order to sense it.
(sometimes referred to as a stomping gait since patients may lift their legs very high to hit the ground hard.)

Question 19

what causes a sensory gait

Answer 19

B12 deficiency
tabes dorsalis)
diseases affecting the peripheral nerves (uncontrolled diabetes)