Introduction to gait abnormalities
Contents 1 Pinyin 2 English reference 3 Overview 4 Disease name 5 English name 6 Alias of gait abnormality 7 Classification 8 ICD number 9 Cause 10 Clinical manifestations of gait abnormality 10.1 Corticospinal tract lesions 10.2 Apraxia of gait Gait 10.3 Marche à petit pas 10.4 Extrapyramidal pathology 10.5 Cerebellar ataxia 10.6 Drunken gait 10.7 Sensory ataxia 10.8 Transthreshold gait 10.9 Myopathic gait 10.10 Hysterical gait 11 Laboratory examination 12 Auxiliary examination 13 Differential diagnosis 14 Treatment of abnormal gait 15 Related drugs 16 Related examinations attached: 1 Acupoints for treating abnormal gait 1 Pinyin
bù tài yì cháng 2 English reference
Abnormal gait 3 Overview
Abnormal gait can be caused by motor or sensory disorders, and its characteristics are related to the location of the lesion. It can be seen in many neurological or other system diseases. Some typical abnormal gaits are suggestive of certain diseases and can be diagnosed by inspection. For some atypical gaits, detailed examination is necessary. Through analysis and synthesis, it will also be helpful to the diagnosis. The clinical classification of gait abnormalities should be combined with the etiology. 4 Disease name
Abnormal gait 5 English name
abnormal gait
6 Alias of abnormal gait
Abnormal gait 7 Classification
Neurology> Common Symptoms 8 ICD Number
R26.8 9 Causes
Common causes of abnormal gait include the following:
< p> 1. Corticospinal tract lesions can lead to spastic hemiplegic gait and spastic paraplegic gait.2. Bilateral frontal lobe lesions can lead to apraxia of gait.
3. Lesions in the frontal lobe (cortex or white matter) can cause marcheà petit pas.
4. Extrapyramidal lesions can lead to panicked gait and twisted and bizarre gait.
5. Cerebellar lesions lead to dystaxic gait.
6. Alcohol or barbiturate poisoning leads to drunken gait.
7. Others? There are also sensory impairments leading to ataxia gait; weakness of the tibialis anterior and gastrocnemius muscles leading to cross-threshold gait; weakness of the trunk and pelvic girdle muscles leading to myopathic gait; Hysterical gait due to disease. 10 Clinical manifestations of gait abnormalities 10.1 Corticospinal tract lesions
(1) Spastic hemiplegic gait: a unilateral lesion. The upper limb on the affected side is usually in a flexed and adducted posture, the waist is tilted toward the healthy side, and the lower limb is straightened, externally rotated, and swung outward and forward (to compensate for the dragging of the feet caused by weakness of the hip and knee flexors and ankle dorsiflexors). It shows a circle-like gait; mild patients only show a dragging gait of the lower limbs. Seen in the sequelae of stroke, etc.
(2) Spastic paraplegic gait: Severe spastic increase in muscle tone on both sides, the patient's lower limbs are tonic and adducted, accompanied by compensatory trunk movement, walking with difficulty and a scissor-like gait. Commonly seen in children with cerebral palsy, spinal cord trauma, etc. 10.2 Apraxia of gait
Caused by bilateral frontal lobe lesions, commonly seen in hydrocephalus or progressive dementia. The patient has no limb weakness or dyslexia, but is unable to stand on his own or walk normally. His gait is unsteady, uncertain and small, his feet seem to be stuck to the ground, and he is accompanied by obvious hesitation (freezing) and dumping. 10.3 Marcheà petit pas
Found in lesions of the frontal lobe (cortex or white matter). Showing small steps, shuffling, slow starting or turning, and unsteady gait. It is easy to misdiagnose Parkinson's disease gait, but the small gait has a wide base. Swinging movements of the upper limbs, accompanied by cognitive impairment, frontal lobe release symptoms, pseudobulbar paralysis, pyramidal tract signs, and sphincter dysfunction can be used for identification. However, it should be noted that patients with frontotemporal dementia may also suffer from Parkinson's disease. 10.4 Extrapyramidal lesions
(1) Panic gait: seen in advanced Parkinson's disease. When walking, the trunk is bent forward, and the hips, knees and ankles are bent. It is slow to start, difficult to stop and turn, and walks with a small gait along the ground, showing a forward thrust, making it easy to fall. The coordinated swing of the upper limbs disappears.
(2) Dystonia is characterized by abnormal limb or trunk postures, which can affect movement or lead to twisted and bizarre gaits.
10.5 Cerebellar ataxia gait
(1) Cerebellar vermis lesions lead to trunk ataxia, irregular, clumsy, unstable gait with wide base, difficulty in turning, and inability to Go in a straight line. Seen in midline cerebellar tumors and spinocerebellar ataxia.
(2) Lesions in the cerebellar hemisphere lead to unstable gait or large jumping movements (dance-like gait), swaying left and right, and tilting to the affected side. The vision can be partially corrected, and is often accompanied by poor limb discrimination. Seen in cerebellar lesions and multiple sclerosis. 10.6 Drunken gait
Seen in alcohol or barbiturate intoxication. The gait is staggering, wobbling, and leaning forward and backward, as if trying to lose balance and fall, which cannot be corrected by vision. The difference between the gait of cerebellar ataxia and cerebellar ataxia is that drunk people can walk short distances and maintain balance on a narrow base, while cerebellar ataxia always has a broad-base gait. 10.7 Sensory ataxia gait
Found in Friedreich's ataxia, subacute combined degeneration of the spinal cord, multiple sclerosis, tuberculosis and sensory neuropathy. The patient cannot stand with his eyes closed, and is prone to falling when shaking. His vision can be partially compensated when his eyes are opened (Romberg's sign). When walking, the lower limbs move heavily, lifting the feet high, and landing heavily, which is aggravated when walking at night or with eyes closed. 10.8 Cross-threshold gait
Seen in common peroneal nerve palsy, peroneal muscular atrophy and progressive spinal muscular atrophy. Due to weakness of the tibialis anterior and gastrocnemius muscles, foot drop occurs, and the affected limb is raised when walking, as if crossing a threshold. 10.9 Myopathic gait
Seen in progressive muscular dystrophy, etc. Lordosis is caused by weakness of the trunk and pelvic girdle muscles, causing the hips to sway from side to side when walking, like a duck's walk. 10.10 Hysterical gait
It can show a strange gait. Although the muscles of the lower limbs are good, they cannot support the body weight. They sway in all directions as if they are about to fall. The gait drags when walking with assistance, but falls rarely cause injuries. who. Seen in psychogenic diseases. 11 Laboratory tests
Necessary and selective laboratory tests include: blood routine, blood electrolytes, blood sugar, and urea nitrogen. 12 Auxiliary examinations
Necessary and selective auxiliary examinations include:
1. Skull base radiographs, CT and MRI examinations.
2. Cerebrospinal fluid examination.
3. Chest X-ray, electrocardiogram, ultrasound. 13 Differential diagnosis
Through comprehensive analysis, make a symptom diagnosis based on different gait characteristics, and then further consider the cause diagnosis. Gait needs to be observed:
1. The length of the stride.
2. Walking speed.
3. Symmetry on both sides.
4. Flexibility of movement.
5. Coordinated movement of the upper limbs (too little or too much).
6. The position of the head and shoulders.
7. The coordination status of the trunk (leaning forward or backward, leaning left or right).
8. Pelvic mobility (front, back, left, right).
9. The shifting state of the center of gravity during heel strike and walking.
10. The length of the footing period (the period when the heel strikes the ground) and the swimming period (the period when the toe is off the ground), their mutual ratio, and their relationship with trunk movement.
The gait of every normal person is affected by various factors such as height, weight, childhood habits (such as outside gait, inside gait), personality, walking speed, mental state, fatigue, excitement, etc. , attention should be paid to the distinction. 14 Treatment of gait abnormalities
Diagnosis according to the cause and treatment mainly focus on the primary disease. 15 Related drugs
Barbiturates, urea 16 Related tests
Urea nitrogen for the treatment of gait abnormality at acupoint Bulang
Sound: bùláng English: Bùláng KI22 Overview: Bu Lang is another name for the meridian point, namely Bu Lang. See "Essential Prescriptions for Emergency Preparations". The Corridor is... The Corridor
gKI22;bùláng;K22;KI22 Overview: The Corridor is the name of a meridian point (BùlángKI22). From "Acupuncture A and B... Chesshu"
Twelve points of Chesshu: The twelve points of Chesshu are Yufu, Orzhong, Shenzang, Lingxu, Shenfeng and Bulang. There are 12 acupoints on the left and right. Published "Huangdi Nei Jing Su Wen·Qi Cai Lun". ... Acupoint properties
When selecting acupoints, there is a basis. At present, the understanding of acupoint properties in the acupuncture community is not completely consistent. With the deepening of acupoint research, it will gradually become more reasonable in the future.
... Chest Shu Twelve Points