Panicky gait

Introduction When a patient suffers from certain diseases, a large change in gait is caused. Panic gait: After the start, the small step quickly moves forward, the foot does not leave the ground, wipes the ground, and the body leans forward, there is a tendency to fall to the ground, which is the typical gait of patients with tremor palsy, also known as Parkinson's disease.

Cause

Seen from tremor paralysis and diseases that can cause tremor paralysis syndrome. Some clear history of trauma can also cause a change in the patient's gait transiently or permanently.

The exact cause of tremor paralysis is still unknown. Genetic factors, environmental factors, ageing, oxidative stress, etc. may all be involved in the degenerative death process of PD dopaminergic neurons. Smoking was negatively correlated with the occurrence of PD, which was consistently concluded in several studies. Caffeine also has a similar protective effect. Severe brain trauma may increase the risk of PD. May be the result of interactions between multiple genes and environmental factors.

an examination

Related inspection

Brain CT examination of brain MRI posture and gait

1. Mainly rely on medical history, clinical symptoms and signs. According to the characteristics of insidious onset and gradual progress, unilateral involvement and development to the opposite side, the performance is difficult to start, but after a step, it rushes forward at a very small pace, the faster and faster, the small step, Can not stop in time, and the difficulty of turning, called the gait gait.

2. The treatment of levodopa preparation is more effective in supporting diagnosis.

3. There is no abnormality in routine blood and cerebrospinal fluid examination.

4. There is no characteristic change in head CT and MRI.

5. Olfactory examination can be found in patients with PD with loss of sense of smell.

6. Dopamine uptake functional PET imaging with 18F-dopa as a tracer showed reduced dopamine transmitter synthesis.

Differential diagnosis

1. After gait after drunkenness: The patient is like a drunkard. When walking, the center of gravity is unstable, and the pace is disordered and inaccurate. Most common in cerebellar disorders, alcoholism or certain sedatives.

2, gait: the body swings when walking, like a penguin, common in rickets, Kashin-Beck disease, and progressive muscular dystrophy or bilateral congenital dislocation of the hip and other diseases.

3. Scissor -style gait: When walking, the two knees cross each other to make the legs change like scissors, which is seen in patients with cerebral palsy and paraplegia.

4, ataxia gait at the start of a foot lift, suddenly falling, eyes down, the feet are wide, to prevent the body from dumping, characterized by the need to squint to walk, can not maintain body balance when closed . Found in patients with spinal cord paralysis.

5, intermittent claudication gait refers to the patient walking, suddenly one or both sides of the lower extremity weakness, after rest and then walk again and then there will be the above situation, no regularity. The occurrence of this condition is often caused by spinal cord lesions, as well as some thrombotic diseases, which need to be taken seriously.

6. Cross-threshold gait This is due to the relaxation of the tendon muscles of the ankle and the sagging of the affected side. It is characterized by the improvement of the hips and knees when walking, the rubbing of the toes, and small steps. Common diseases are sciatic nerve palsy, multiple nerve palsy or multiple neuritis.

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