Sensory ataxia gait

Introduction Sensory ataxia gait, this refers to the deep sensory dysfunction is characterized by a large stride when walking, the legs are wider, the foot height is higher, the foot is strong on the ground, and the eyes are both eyes. It can be partially relieved when blinking, unstable or even unable to walk when closed eyes, often accompanied by sensory disturbances. Romberg sign is positive in subacute combined degenerative spinal cord paralysis.

Cause

Sensory ataxia gait is seen in subacute combined degenerative spinal cord, hereditary ataxia, post-surgical lesions, diabetes and cancerous neuropathy.

an examination

Related inspection

Posture and gait magnetic resonance imaging (MRI) cross-walking test finger-nose test electromyography

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Sensory ataxia gait is more likely to have spinal cord lesions. Spinal MRI, cerebrospinal fluid examination, electromyography and somatosensory evoked potential should be selected.

Differential diagnosis

Differential diagnosis of sensory ataxia gait:

1 drunken gait: because the center of gravity is not easy to control, the distance between the legs is widened when walking, and the body swings to the sides after the leg is lifted. The upper limb often shakes in the horizontal direction or before or after, sometimes it cannot stand, and the position is unstable when changing position. Obviously, it is impossible to take a straight line. This kind of gait is also called " gait".

2 Sensory ataxia gait: This refers to the deep sensory dysfunction caused by a large stride when walking, the legs are wider, the foot height is higher, and the foot is strong and the ground eyes can be partially relieved when looking at the two eyes. When the eye is closed, it is unstable or even unable to walk. It is often accompanied by a sensory disorder. The Romberg sign is positive in the subacute combined degenerative spinal cord.

3 : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : When the external rotation step is carried out, the pelvis is raised. In order to avoid the toe towing the ground and then move outward and then move forward to the front, it is also called a circle-like gait, which is caused by a lesion of one side of the pyramidal beam and is more common in cerebrovascular diseases.

4 sacral paraplegia gait: due to the increased tension of the lower extremity adductor muscle group, the legs cross the shape when walking, such as scissors, also known as scissors gait, seen in the transverse spinal cord damage cerebral palsy.

5 flustered gait: due to increased muscle tension at the beginning of the body, when walking slowly, the pace of the small feet rubbed the ground and the two upper limbs swayed before and after the movement of the torso forward tilted the center of gravity forward, so the small step rushed forward like chasing the center of gravity And can not immediately stop like a panic, also known as chasing the heart gait or rushing gait seen in tremor paralysis and diseases that can cause tremor paralysis syndrome.

6 Cross-threshold gait: Because the foot of the disease is drooping, the affected limb is lifted away from the ground, such as the posture of crossing the threshold.

7 Swing gait: Because the pelvic muscles and the psoas muscles are weak, the lower limbs and the pelvic muscles are atrophy. When standing, the lordosis is raised to maintain the balance of the center of gravity. When walking, the pelvis cannot be fixed due to muscle weakness, so the hips swing like a duck. Called duck step is seen in progressive muscular dystrophy.

8 Dance gait: There is a large irregular involuntary movement of the limb during walking. The sudden extremity of the lower extremity is twisted or the dance is unstable. It is seen in the lesion of the new striatum.

9 Star trail gait: When the patient moves backwards to the affected side when the eye is closed, the deviation is reversed in the opposite direction. The forward and backward retreats are repeated and the footprint is star-shaped, which is seen in the vestibular labyrinth lesion.

10 gluteal muscle paralysis gait: one side of the gluteus medius lesions when walking torso to the affected side, and swinging left and right in the gluteus medius lesions polymyositis, progressive malnutrition.

11 spinal cord intermittent break: the performance of the beginning of walking asymptomatic to a certain distance (about 1-5 minutes), one or both sides of the lower limbs unable to rest after a rest, seen in spinal artery endarteritis spinal cord development abnormal spinal canal stenosis, etc. .

12 rickety gait: can be expressed in a variety of strange gait, such as gait gait gait often accompanied by other functional disorders.

13 Congenital myotonia: When the force is strong, the skeletal muscles are strong and straight, so when walking or running, if you want to stop the muscle tension, you can't immediately relax and fall.

Sensory ataxia gait is more likely to have spinal cord lesions. Spinal MRI cerebrospinal fluid examination, electromyography and somatosensory evoked potential should be selected.

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