Walking/gait abnormalities

Alternative names:

gait/walking abnormalities

Definition:

Unusual and uncontrollable problems with walking.

Considerations:

The pattern of how a person walks is called the gait. Many different types of gait abnormalities are produced unconsciously. Most, but not all, are due to some physical malfunction.

Some gait abnormalities are so characteristic that they have been given descriptive names:

• propulsive gait (characterized by a stooped, rigid posture, with the head and neck bent forward)
• scissors gait (characterized by legs flexed slightly at the hips and knees, giving the appearance of crouching, with the knees and thighs hitting or crossing in a scissors-like movement)
• spastic gait (characterized by a stiff, foot-dragging walk caused by one-sided, long-term, muscle contraction
• steppage gait (characterized by foot drop where the foot hangs with the toes pointing down, causing the toes to scrape the ground while walking)
• waddling gait (characterized by a distinctive duck-like walk that may appear in childhood or later in life)

Abnormal gait may be caused by disease in many different areas of the body. Typical groupings might consist of:

• vestibular (the inner ear is responsible for maintaining balance; damage results in vertigo)
• central nervous system (diseases of the brain that cause muscular problems resulting in gait disturbance such as multiple sclerosis and cerebral palsy)
• spinal cord abnormalities (disease, trauma, degeneration)
• peripheral nerve diseases (nerves from the spinal cord to the muscles may be damaged by disease or trauma and result in gait abnormalities)
• degenerative muscle diseases (muscular dystrophy, myotonic dystrophy, myositis)
• skeletal abnormalities and disease
• arthritis
• skin conditions (plantar warts, bunions, ingrown toenails, ulcers)
• toxic reactions (alcohol, drugs, toxins)

Common causes:

ABNORMAL GAIT IN GENERAL

• trauma
• foot problems (such as a callus, corn, ingrown toenail, wart, pain, skin ulcer, swelling, spasms)
• chondromalacia patellae
• fracture
• hemophilia
• immunization (soreness in the leg or buttocks)
• legs that are different lengths
• myositis
• tight or uncomfortable shoes
• shin splints
• infection
• tendinitis
• torsion of the testis
• conversion disorder (a psychological disorder)

CAUSES OF SPECIFIC GAITS

• Propulsive gait:
  • carbon monoxide poisoning
  • manganese poisoning
  • Parkinson's disease
  • drugs including phenothiazines, haloperidol, thiothixene, loxapine, metoclopramide, and metyrosine (usually drug effects are temporary)

• Scissors gait:
  • cerebrovascular accident (stroke)
  • cervical spondylosis with myelopathy (a problem with the vertebrae in the neck)
  • liver failure (hepatic failure)
  • multiple sclerosis
  • pernicious anemia
  • spinal cord trauma
  • spinal cord tumor
  • syphilitic meningomyelitis
  • syringomyelia

• Spastic gait:
  • brain abscess
  • brain tumor
  • cerebrovascular accident (stroke)
  • head trauma
  • multiple sclerosis

• Steppage gait:
  • Guillain-Barre syndrome
  • herniated lumbar disk
  • multiple sclerosis
  • peroneal muscle atrophy
  • peroneal nerve trauma
  • poliomyelitis
  • polyneuropathy
  • spinal cord trauma

• Waddling gait:
  • congenital hip dysplasia
  • muscular dystrophy
  • spinal muscle atrophy

Note: There may be other causes of gait abnormalities. This list is not all inclusive, and the causes are not presented in order of likelihood. The causes of this symptom can include unlikely diseases and medications. Furthermore, the causes may vary based on age and gender of the affected person, as well as on the specific characteristics of the symptom such as quality, time course, aggravating factors, relieving factors, and associated complaints. Use the Symptom Analysis option to explore the possible explanations for gait abnormalities, occurring alone or in combination with other problems.