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Gait Disorders

What is Gait Disorder?

Gait Disorder is a deviation from normal walking. Watching a patient walk is the most important part of the neurological examination. Normal gait requires that many systems, including strength, sensation and coordination, function in an integrated fashion. Many common problems in the nervous system and musculoskeletal system will show up in the way a person walks.

Functional Gait Disorders A functional movement disorder means that there is abnormal movement or positioning of part of the body due to the nervous system not working properly (but NOT due to an underlying neurological disease).

A variety of gait (walking) problems can occur as part of a functional disorder. As with all functional disorders, these do not occur because people walk like this on purpose. The movement and gait is involuntary.

These are the most common types of functional gait disorder

1. Dragging Gait of Functional Leg Weakness. One of the most common functional gait disorders is the ‘dragging’ gait seen in patients with functional weakness of one leg. People with this kind of leg weakness find that the leg drags along the ground. The ankle is often turned in or out. Some people feel like their foot is stuck to the ground almost like a magnet.

2. Sudden knee buckling. Typically, this is also associated with a finding of functional weakness in one or both legs. Sometimes if both legs buckle at the same time it leads to a ‘drop attack’ (sudden fall to the ground without an obvious ‘blackout’), although it is important to recognize that there may be other causes of this such as knee problems.

3. Small slow steps ('walking on ice') gait. This is a generally unsteady gait where the person takes small steps almost as if they are 'walking on ice'. The legs are quite stiff and feet far apart. The reason people get in the habit of walking like this is often because they have had a fall and are concerned about future falls.

4. Swaying gait. This is a type of walking where the person sways from side to side, especially in their upper body, and the legs tend to correct the movements. The person looks as if they are going to fall over but then is able to catch themselves.

5. Hyperkinetic gait. Functional movement disorders can sometimes cause quite dramatic excessive movements of the arms, trunk or leg. Some people have these particularly when they walk.

6. Crouching gait. This is a rare form of functional gait disorder in which the person looks as if they are crouching. This is often associated with a fear of falling.

How is the diagnosis made?

The diagnosis of a functional gait disorder is usually made by a neurologist. It can be a difficult diagnosis to make because it requires expert knowledge of the full range of movement disorders due to neurological disease.

There are many diseases which produce these symptoms. At Pinehurst Neurology, our doctors are especially skilled at the neurologic examination to begin to discover the cause of a walking problem. Additional studies may include blood test, CT or MRI scans or nerve conduction studies. Once a cause (or etiology) is determined our doctors can make a plan to improve your walking. We also work closely with the physical therapists in our community who can be invaluable in helping out patients with gait disorders.

Click to learn more about Gait Disorders or to schedule an appointment with one of our board certified neurologists call 910-295-6868

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