Gait disturbance resident survival guide: Difference between revisions
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{{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo M.D.]] | {{CMG}}; {{AE}}[[User:MoisesRomo|Moises Romo M.D.]] | ||
'''''Synonyms and Keywords:'''''<br /> | '''''Synonyms and Keywords:''' [[disequilibrium]], [[ataxia]], [[spasticity]], [[paresis]], [[hypokinesia]], [[imbalance]]''<br /> | ||
==Overview== | ==Overview== | ||
[[Disequilibrium|Gait disturbance]] refers to an impaired [[sense]] or absence of [[Balance disorder|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== | ==Causes== | ||
===Life Threatening Causes=== | ===Life Threatening Causes=== | ||
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. | Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated. | ||
* [[Intoxication|Intoxications]] | *[[Intoxication|Intoxications]] | ||
*[[Head trauma]] | *[[Head trauma]] | ||
*[[Carbon monoxide poisoning]] | *[[Carbon monoxide poisoning]] | ||
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===Common Causes=== | ===Common Causes=== | ||
* [[Osteoarthritis]] | *[[Osteoarthritis]] | ||
* [[Pelvic girdle pain]] | *[[Pelvic girdle pain]] | ||
* [[Ataxia]] | *[[Ataxia]] | ||
* [[Hip dysplasia]] | *[[Hip dysplasia]] | ||
* [[Polio]] | *[[Polio]] | ||
* [[Multiple sclerosis]] | *[[Multiple sclerosis]] | ||
* [[Cerebellar lesion|Cerebellar lesions]] | *[[Cerebellar lesion|Cerebellar lesions]] | ||
* Cerebellar degeneration | *[[Cerebellum|Cerebellar]] [[degeneration]] | ||
* [[Parkinson's disease]] | *[[Parkinson's disease]] | ||
==Diagnosis== | ==Diagnosis== | ||
Shown below is an algorithm summarizing the diagnosis of Gait disturbance according to the American Academy of Neurology guidelines. | Shown below is an algorithm summarizing the diagnosis of Gait disturbance according to the American Academy of Neurology guidelines:<ref name="pmid24132835">{{cite journal |vauthors=Giladi N, Horak FB, Hausdorff JM |title=Classification of gait disturbances: distinguishing between continuous and episodic changes |journal=Mov Disord |volume=28 |issue=11 |pages=1469–73 |date=September 2013 |pmid=24132835 |pmc=3859887 |doi=10.1002/mds.25672 |url=}}</ref> | ||
{{Family tree/start}} | {{Family tree/start}} |
Revision as of 17:57, 27 October 2020
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 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Occurs consistently with locomotion (can vary in severity) | Occurs intermittently during locomotion (may vary in severity and frequency) | Suffers from more than one continuous disturbance, or continuous and episodic disturbances, for example, are possible. | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Continuous | Episodic | Mixed | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Transient inability to create effective stepping | Unintentional increase in speed, usually with small steps | Transient loss of balance | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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, axial postural deformities | Secondary to musculo-skeletal or central pain | Higher level | Sometimes it may be difficult to classify the continuous nature of the gait disturbance | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Ataxic | Spastic | Bradykinetic/hypokinetic | Dyskinetic/Choreic/Dystonic | Paretic | Trunkal | Antalgic | Frontal | 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.