Star trail gait

Introduction Star trail gait: seen in the vestibular labyrinth lesions. When the patient closes his eyes, he is deflected to the affected side, and when he retreats, he is deflected in the opposite direction. Thus, the advancement and the retreat are repeated, and the footprint is star-shaped.

Cause

(1) Viral infection: After the disease, serum levels were measured, and the herpes simplex and herpes zoster virus titers were significantly increased.

(B) vestibular nerves are stimulated: vestibular nerves suffer from vascular compression or arachnoid adhesions, and even due to stenosis of the internal auditory canal caused by hypoxic degeneration, caused by the stimulation of nerve discharge.

(3) Lesion factors: There may be an autoimmune response.

(D) Diabetes: Schuknecht et al (1972) reported that diabetes can cause degeneration of vestibular neurons, leading to repeated vertigo attacks.

Some patients with pathological examination after vestibular nerve severing can be found that the vestibular nerve has arcing or scattered degeneration and regeneration, nerve fiber reduction, ganglion cell vacuolization, and increased neuronal collagen deposits.

an examination

Related inspection

Vestibular function check closed eyes upright test posture and gait

The closed-head erect test, also known as the Romberg test. The subject closed his eyes upright, his feet together, his hands clasped to the chest and tightened to the sides or arms extended forward to observe the stability of standing. Because the person with labyrinth has a short incubation period before the dumping occurs, the time taken for the examination should not be less than 60s. The vestibular function is normal and there is no spontaneous dumping. The abnormal ones have different directions of inclination depending on the lesion or degree. For example, those with vaginal lesions have more vestibular dysfunction with a weaker atrium function, and the dumping direction is dumped. Can change with the head position; cerebellar lesions spontaneous tilting direction always toward the affected side or backwards, and the direction of the dumping is not affected by the position of the head; the tilting direction of patients with spinal cord paralysis is not affected by the head position, but its dumping It is characterized by no shaking in a fixed direction and is mainly caused by the shaking of the legs. Therefore, hand-held foreign objects (such as trunks, walls, etc.) can stand, but not when dizzy.

Differential diagnosis

1. Drunken gait is seen in cerebellar tumor, cerebrovascular disease, tumor, inflammation, degeneration, cerebellopontine angle tumor, olive bridge cerebellar degeneration, alcoholic cerebellar degeneration, cancerous spinal cerebellar degeneration J brain atrophy Encephalitis, brain stem tumor, posterior inferior cerebellar artery thrombosis, frontal lobe lesion, inner ear vertigo, vestibular neuronitis, etc.

2, sensory ataxia gait seen in subacute combined degeneration, spinal cord hernia, hereditary ataxia, posterior cord lesions, diabetes and cancerous neuropathy.

3, spastic hemiplegic gait is seen in cerebral vascular and encephalitis, brain trauma and other sequelae.

4, spastic paraplegia gait seen in spastic paraplegia, cerebral palsy, transverse spinal cord injury, cerebral palsy, hereditary spastic paralysis, lateral sclerosis, corticospinal degeneration.

5, panic gait seen in the tremor paralysis and can cause tremor paralysis syndrome.

6, cross-threshold gait seen in the common nerve paralysis.

7. Swing gait is seen in progressive muscular dystrophy. Polymyositis, pseudohypertrophic muscular dystrophy, and joint dislocation.

8, dance gait seen in small dance and chronic progressive chorea and other new striatum lesions.

9, star trail gait seen in the vestibular labyrinth lesions.

10, gluteal muscle paralysis gait side of the gluteus medius lesions, polymyositis, progressive malnutrition.

11, intermittent breaks seen in spinal arterial endarteritis, spinal cord dysplasia, spinal stenosis, spinal vascular disease, subacute necrotizing vertebral inflammation, spinal cord compression and macrovascular disease affecting spinal cord blood supply.

12. Cancer gait is seen in people with mental factors and rickets.

13, congenital myotonia due to forced skeletal muscle tonic, so when walking or running, if you want to stop at that time, muscle tension can not immediately relax, and fall.

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