DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20170437

Clinical profile of neurological gait ataxia: a hospital based study

Rajesh Kashyap, . Laxaminand, Sunil Sharma, Thakur Prashant Singh, Vishal Vishnoi, Manish Kumar Thakur

Abstract


Background: Gait disorders are major causes of functional impairment and morbidity especially in the elderly. Most gait disorders in older person are multifactorial, including neurological and non -neurological components. The aim of the study was to determine different neurological causes of gait disorders in elderly as well as in young adults.

Methods: A total of 155 patients with gait ataxia were included and studied for demographic profile, clinical features, mode of presentation and aetiology of neurological gait ataxia.

Results: Of the 155 patients enrolled in the study for gait disability, the most common cause of gait disability was cerebrovascular accidents 48 (31%) followed by lower motor neuron (LMN) paraparesis20 (12.9%), compressive myelopathy 17 (11%) and infectious causes were reported in 13 (8.4%) patients. Other causes were non-compressive myelopathy 8 (5.2%), Parkinsonism 8 (5.2%), degenerative diseases 6 (3.9%), diabetic amyotrophy 5 (3.2%), sensory neuropathy, hydrocephalus, myopathy and space occupying lesions in 4 (2.6%) patients each.

Conclusions: The two most common causes of gait instability in Sub-Himalayan region are cerebrovascular accidents and LMN paraparesis. The LMN parapersis is associated with significant falls.


Keywords


Cerebrovascular accidents, Gait instability, LMN paraparesis, Sub-Himalayan region

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References


Snijders AH, van de Warrenburg BP, Giladi N, Bloem BR. Neurological gait disorder in elderly people: clinical approach and classification. Lancet Neurol. 2007;6(1):63-6.

Bloem BR1, Haan J, Lagaay AM, van Beek W, Wintzen AR, Roos RA. Investigation of gait in elderly subjects over 88 years of age. J Geriatr Psychiatry Neurol. 1991;5(2):78-80.

Sudarsky L. Gait disorders: prevalence, morbidity andaetiology. Adv Neurol. 2001;87:111-3

Guralnik JM, Ferrucci L, Balfour JL, Volpato S, Di Iorio A. Progressive vs catastrophic loss of the ability to walk: implications for the prevention of mobility loss. J Am Geriatr Soc. 2001;49(11):1463-70.

Grillner S, Parker D, El Marina A. Vertebrate locomotion- a lamprey perspective. Ann NY Acad Sci. 1998;860:1-6.

Jankovic J, Nutt JG, Sundarsky L. Classification, diagnosis, and etiology of gait disorder. Adv Neurol. 2001;87:119-21.

Ostchega Y, Harris TB, Hirsch R, Parsons VL, Kington R. The prevalence of functional limitations and disability in older persons in the US: data from the national health and nutrition examination survey III. J Am Geriatr Soc. 2000;48(9):1132-5.

Alexander NB. Gait disorder in older adults. J Am Geriatr Soc. 1996;44:434-51.

Hough JC, Mchenary MP, Kammer LM. Gait disorder in elderly. Am Fam Pract. 1987;30:191-6.

Sudarsky L. Gait disorders: prevalence, morbidity andaetiology. Adv Neurol. 2001;87:111-3.

Centers for Disease Control and Prevention (CDC). Public health and aging: Non fatal injuries among older adults treated in hospital emergency department- US, 2001. MMWR Morb Mort Wkly Rep. 2003;52(42):1019-21.

Centers for Disease Control and Prevention (CDC). Self- reported falls and fall related injuries among persons aged >or=65 years- US, 2006. MMWR Morb Mort Wkly Rep. 2008;57:225-6.

Cawthon PM, Harrison SL, Barrett-Connor E, Fink HA, Cauley JA, Lewis CE. Alcohol intake and its relationship with bone marrow density, falls and fracture risk in older men. J Am Geriatr Soc. 2006;54:1649-51.

Sacco RL, Wolf PA, Gorelick PB. Risk factors and their management for stroke prevention. Neurology 1999;55(7):15-24.

IDF Diabetes Atlas, 4th edition. International Diabetes Federation, 2009.

National programme for prevention and control of cancer, diabetes, cardiovascular diseases and stroke (NPCDCS) operational guidelines. Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India.