Heavy lower body movements, high foot lift, heavy landing

Introduction The lower limbs are heavy and they feel heavy when they lift their feet high. They feel heavy when they land. This is the symptom of sensory ataxia gait.

Cause

Found in Friedreich ataxia, subacute combined spinal degeneration, multiple sclerosis, spinal cord spasm and sensory neuropathy.

an examination

Related inspection

EEG examination

The patient can't stand with closed eyes, and it is easy to fall when shaking. When the eye is blinking, the vision can be partially compensated (Romberg sign); when walking, the lower limbs are heavy, high, and heavy, and when walking or closing the eyes, it is aggravated.

Differential diagnosis

The differential diagnosis of lower limbs, heavy lifting, and heavy landing:

1. Drunk gait: Because the center of gravity is not easy to control, the distance between the legs is widened when walking. After lifting the leg, the body swings to the sides and the upper limbs often swing horizontally or forward or backward. Sometimes you can't stand still, it's more stable when you change your position, you can't take a straight line. This gait is also called " gait", which is seen in the ataxia caused by cerebellar lesions, such as cerebellar tumor, cerebrovascular disease, tumor, inflammation, degeneration, cerebellopontine angle tumor, olive bridge cerebellar degeneration, alcohol toxicity Cerebellar degeneration, cancerous spinal cerebellar degeneration. Cerebellar atrophy, cerebellar encephalitis, brainstem tumor, posterior inferior cerebellar artery thrombosis, frontal lobe lesion, inner ear vertigo, vestibular neuronitis, etc.

2, sensory ataxia gait: This refers to people with deep sensory impairment. It is characterized by a large stride when walking, a wide spacing between the legs, a high foot lift, a strong foot hitting the ground, two eyes gazing at the two feet, partial relief when blinking, unstable or even walking when closing the eyes. Often accompanied by sensory disturbances, Romberg sign positive, seen in subacute combined degenerative spinal cord paralysis.

3, spastic hemiplegia gait: the hemiplegia of the affected side of the lower limb due to high extensor muscle tension and longer, and flexion is difficult. When the patient walks, the coordinated swinging motion of the upper limbs of the hemiplegia disappears, and the adductor, pronation and flexion postures are performed. The lower limbs are straightened and externally rotated. When the steps are raised, the pelvis is raised, and the toe is dragged outward to move forward and then to the front. Therefore, it is also called a circle-like gait. It is caused by damage of one side of the pyramidal tract, which is more common in cerebrovascular diseases.

4, sputum paraplegia gait: due to the increased tension of the lower extremity adductor muscle group caused by walking the legs to the inside when walking, shaped like scissors, it is also called scissors gait. Found in transverse spinal cord injury, cerebral palsy and so on.

5, flustered gait: due to increased muscle tension, slow start, walking small steps, rubbing the feet, the two upper limbs swinging back and forth movement lost, the trunk leaned forward, the center of gravity moved forward, so small steps Rush forward, such as chasing the center of gravity and can not stop immediately, like a panic, also known as chasing the heart gait or rushing gait. Seen from tremor paralysis and diseases that can cause tremor paralysis syndrome.

6, cross-threshold gait: due to the sagging of the diseased foot, in order to make the toes off the ground, the limbs are lifted very high, such as crossing the threshold. Seen in the general nerve paralysis and so on.

7, swing gait: due to pelvic muscle and psoas muscle weakness, lower limbs and pelvic muscle atrophy, standing vertebral lordosis to maintain the body's center of gravity balance, walking muscles can not be fixed due to muscle weakness, so the hips swing like a duck Also called duck step. Found in progressive muscular dystrophy.

8. Dance gait: There are large, irregular and involuntary movements of the limbs while walking. The lower extremity suddenly squats, the upper limbs are twisted, the road is unstable, and it is jumping or dancing. Found in the lesions of the new striatum.

9. Star trail gait: When the patient closes his eyes, he is inclined to the affected side, and when he retreats, he is deflected in the opposite direction. The advance and the backward are repeated, and the footprint is star-shaped. Found in the vestibular labyrinth lesions.

10, gluteal muscle paralysis gait: one side of the gluteus medius lesion, the torso bends to the affected side while walking, and swings left and right. Found in gluteus medius lesions, polymyositis, progressive malnutrition, etc.

11, spinal cord intermittent break: the performance of the beginning of walking asymptomatic, to a certain distance (about 1-5 minutes), one side or both sides of the lower limbs weakness, improved after a break. Found in spinal arterial endarteritis, spinal cord dysplasia, spinal stenosis.

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

13, congenital myotonia: when the force of skeletal muscle tonic, so when walking or running, if you want to stop at that time, muscle tension can not immediately relax, and fall. The patient can't stand with closed eyes, and it is easy to fall when shaking. When the eye is blinking, the vision can be partially compensated (Romberg sign); when walking, the lower limbs are heavy, high, and heavy, and when walking or closing the eyes, it is aggravated.

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