ABSTRACT
Many disease processes can affect any part of the nervous system. These include tumours, infections, demyelination such as in multiple sclerosis (Fig. 11.1), injury, bone disorders, congenital disorders, hereditary disease, vascular disorders, degenerative disorders, toxicity and metabolic disorders
OBSERVE GAIT
Watch the person walk normally, on heels, on toes and ‘tightrope’ walking
Brain
• Festinating gait which is slow and shuffling Parkinson’s disease
• Hemiplegic gait in which the patient swings the leg around to step forward
Cerebrovascular accident
• Diplegic gait in which the patient’s legs are circumducted
Bilateral lesions close to the ventricles
• Choreiform gait with irregular, jerky, involuntary movements
Some basal ganglia disorders such as Huntington’s chorea
• Ataxic gait with wide-stepping, irregular, lurching steps and truncal instability
Cerebellar disease (and severe loss of proprioception)
• Scissors gait Cerebral palsy
• Spastic gait with stiffness and dragging of the foot
Brain abscess, tumour, trauma and cerebrovascular accident
Spinal cord
• Scissors gait
• Neuropathic high-stepping gait
Cervical spondylosis, trauma and tumours. Caused by nerve root compression
Lumbar disc protrusion
Peripheral nerves
• Neuropathic high-stepping gait Peripheral neuropathy
• Any gait abnormality Multiple sclerosis may affect any part of the nervous system and could therefore result in an assortment of gait abnormalities (Fig. 11.1)
Musculoskeletal disorders, vestibular disorders, age, foot problems and visual problems
with multiple sclerosis.
