Lower limb dragging gait

Introduction Lower limb towing gait is a clinical manifestation of cortical spinal cord lesions in gait abnormalities. Cortical spinal cord lesions, spastic hemiplegic gait is unilateral lesions. The upper limbs of the diseased side are usually in the flexion and adduction postures, the waist is inclined to the healthy side, the lower limbs are straight and externally rotated, and the outward swinging is used to compensate the hip, the knee flexor and the dorsiflexion muscle.

Cause

Cortical spinal cord lesions can lead to spastic hemiplegic gait and spastic paraplegia. The common causes of abnormal gait are as follows:

1. Cortical spinal cord lesions can lead to spastic hemiplegic gait and spastic paraplegia.

2. Bilateral frontal lobe lesions can lead to a lost gait.

3. Frontal (cortical or white matter) lesions can lead to small gait (marcheà petit pas).

4. Extrapyramidal lesions can lead to panic gait and distorted, odd asynchronous state.

5. Cerebellar lesions lead to ataxia gait.

6. Alcohol or barbiturate poisoning leads to drunken gait.

7. Others have sensory disturbances leading to ataxia gait; due to weakness of the tibialis anterior and gastrocnemius muscles, leading to cross-threshold gait; trunk and pelvic muscle weakness leading to myopathy gait; palpitations caused by psychogenic diseases.

an examination

Related inspection

Neurological examination of X-ray lipiodol

(1) spastic hemiplegic gait: a unilateral lesion. The upper limbs of the diseased side are usually flexed and adducted, the waist is inclined to the healthy side, the lower limbs are straight and externally rotated, and the front swings outward (compensating for the hip, knee flexor and dorsiflexion caused by weakness), while walking A circled gait; mild patients only show lower limb towing gait. Found in the sequela of stroke and so on.

(2) sacral paraplegia gait: bilateral severe sacral muscle tension increased, patients with lower extremity tonic adduction, with compensatory trunk movement, walking effort, scissor-like gait. Common in children with cerebral palsy, spinal cord trauma and so on.

Differential diagnosis

Differential diagnosis of lower limb towing gait:

1. Cross-threshold gait: The common peroneal nerve is composed of L4-S3, and its damage causes dorsiflexion, abduction and adduction, and obstacles to the toe, as well as anterior and lateral sensation of the lower leg.

2, "duck step" gait: serious pseudo-fat large malnutrition is a clinical manifestation of muscular dysfunction, manifested as two feet open, walking slowly swinging, showing a special "duck step" gait. Muscular dystrophy is a group of primary skeletal muscle necrotic diseases characterized by progressive skeletal muscle weakness caused by genetic factors. It is clinically characterized by progressive and aggravated skeletal muscle atrophy and weakness in varying degrees and distribution. . Can also affect the heart muscle.

3, stagnation gait: gait abnormalities can be caused by exercise or sensory disturbances, and its characteristics are related to the lesion site. Hysteric gait: It can express grotesque gait. Although the muscle strength of the lower limbs is good, but it can not support the weight, it swings in all directions and seems to fall. When walking, the gait is dragged, but it is rare to fall. Seen in heart disease.

4, drunken gait: drunken gait because of the center of gravity is not easy to control, the leg spacing is widened when walking, the body swings to the sides after the leg is unstable, the upper limbs often horizontally or before or after shaking, sometimes can not stand, conversion When the position is unstable, it is more obvious that it cannot go straight.

5, cock gait: cock gait; standing two thighs close, the calf is slightly separated, the feet stand like a toe, walking like a ballet is a sharp walk.

6, gait: gait is a typical abnormal gait. When walking, the body swayed from side to side, showing a duck step. Common in neurological disorders, rickets, Kashin-Beck disease, progressive muscular dystrophy or bilateral congenital dislocation of the hip.

7, swing gait: duck step or swing step, is a common sign of congenital pulp dislocation, unilateral dislocation appears claudication, bilateral dislocation, standing pelvis forward, hips back, waist lordosis, abdominal bulge, When walking, it is called a duck step or a swing step. It walks a little faster, that is, it is easy to fall.

The material in this site is intended to be of general informational use and is not intended to constitute medical advice, probable diagnosis, or recommended treatments.