Clinical Neurology · Neurological Examination
Gait Disorders
Common abnormal gait patterns encountered on neurological examination, with their characteristic features and the lesions or conditions in which they are seen.
| Gait | Characteristics | Seen in |
|---|---|---|
| Ataxic sensory | Wide based, jerky, worse with eyes closed. | SACD, MS, tabes dorsalis, sensory neuropathy. |
| Ataxic cerebellar | Wide based, staggering, unable to walk tandem (in straight line). | Lesions of vermis or cerebellar hemisphere (fall to same side of lesion). |
| Spastic | Arm held in flexion and adduction, legs stiff held in extension, circumduct or scissoring if bilateral disease. | Lesion of pyramidal tracts. |
| Parkinsonian | Slow, rigid, shuffling, short steppage, stooped posture, propulsion (tendency to fall forwards), loss of associated movements. | Various akinetic rigid syndromes. |
| March a petits pas | Slow, shuffling, short steppage gait, resembles parkinsonian. | Variety of cerebral or spinal disturbance. |
| Apraxic | Slow, shuffling, short steppage, but with normal tone, power and sensation. | Frontal lobe lesion. |
| Steppage | Foot drop, foot drags, lifts high to avoid scraping floor. | Weakness of foot extensors (common or deep peroneal n., L4,5 or cauda lesion). |
| Waddling (myopathic) | Lordosis, pelvis waddles, broad based. | Proximal myopathies. |
| Astasia abasia | Bizarre, non-descript. | Hysterical. |
| Choreatic | Stuttering, dancing gait due to intermittent lordotic and flexion posturing. | Huntington’s disease and other choreas. |
Ahmed Koriesh, MD