Spastic gaits

Hemiplegic gait

Spastic gaits

Pure spastic or paraplegic gait

In patients with carpal tunnel syndrome, there is an excruciating nocturnal pain in the hand, often wakening them and causing them to pace the room flipping or shaking the hand in an effort to obtain pain relief. A pathognomonic gait seen often in autistic and other retarded children, who develop repetitive, self-stimulating mannerisms resembling a variety of flipping-hand gaits

Resembles a double foot drop. Seen in patients with tabes dorsalis, in whom a syphilitic infection causes degeneration of the dorsal columns of the spinal cords. Patients lift the knees high and slap the feet down, placing them irregularly due to sensory ataxia. When standing, they need to use visual cues to avoid swaying and falling over

The slow, deliberate, and searching steps of a blind person are characteristic, and should not confuse an experienced examiner

A unilateral cerebellar lesion, most likely caused by neoplasm, infarct, or demyelinating disease, causes ipsilateral cerebellar signs, with the patient presenting dystaxia of volitional movements (veering or falling in one direction) and of volitionally maintained postures, producing a reeling gait

Bilateral cerebellar signs imply a toxic, metabolic or familiar disorder. Dystaxia of the legs and gait, with little or no dystaxia of the arms, and no dysarthria or nystagmus, suggests a rostral vermis syndrome, most commonly secondary to alcoholism. Truncal ataxia alone implies a flocculonodular lobe or caudal vermian lesion, often a fourth ventricular tumor

Patients circumduct the affected leg, dragging the toe and placing the ball down without a heel strike, with the ipsilateral arm held in partial flexion or, less often, flaccidly at the side

Patients walk with stiff legs, not clearing the floor with either foot, giving the appearance of wading through water because they have to work against the spastic opposition of their own muscles, as if walking in thick, sticky mud; the knees tend to rub together in a scissoring action

A pure spastic paraplegic gait without sensory deficits, developing after birth, implies a corticospinal tract disorder, as in familial spastic paraplegia

Spastic diplegic gait

Spastic-ataxic gait

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