Disorders in balance and gait can be due to many different causes, that apart from being due a neurological cause, can also be due to an orthopedic or inner ear damage or from systemic disease.
These different causes that cause a change in posture and movement, instability, clumsiness in walking, numbness, and a deficit in the sensation of the limbs, should be examined by a Neurologist specializing in Movement Disorders.
Forms of gait disorders:
- Paretic gait due to muscle weakness emanating from peripheral nerve injury.
- Spastic gait in the case of hemiplegia, where the affected limb has an overextension in the knee (with an inability to voluntarily bend) and plantar flexion in the ankle joint, while walking takes a circular course to the outer side by dragging the toes of the foot.
- Scissoring gait due to spasticity of the lower extremities and has a characteristic that one leg approaches the side of the other leg while walking.
- Ataxic gait due to cerebellar disease characterized by irregular steps with an inability to coordinate steps and a tendency to fall.
- Ataxic gait due to polyneuropathy characterized by large amplitude steps of different length and worsened when eyes are closed.
- Short-stepped gait associated with forward trunk flexion, which is the characteristic of parkinsonian patients, with difficulty in initiating and stopping walking, reduced swing of the arms and difficulty in turning.
- Dystonic gait, in patients with dystonia
- Inability to walk
For the diagnosis of balance and gait disorders, the Movement Disorders Neurologist, takes a complete history and performs a comprehensive clinical / neurological examination.
If indicated, the clinical examination is followed by an electromyographic study which will investigate the possible existence of neuropathy or myopathy. Depending on the findings, other, specialized tests may be performed to give the appropriate treatment that will delay the progression of the disease and reduce the symptoms.
