Pediatric Orthopedic Surgeons treating ataxic gait

ATAXIC GAIT

Ataxic gait is frequently characterized by issues with balance, lateral veering, a wider base of support, irregular arm motion, and lack of consistency.

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Ataxic Gait

Doctors recognize the Ataxic Gait because of issues with balance, lateral veering, a wider base of support, irregular arm motion, and lack of consistency. The term Ataxia identifies uncoordinated voluntary movements. In addition, underlining causes may also impair eye movements, speaking and swallowing, hand-eye coordination, walking balance, and other bodily functions. The cause of Ataxia is typically caused by injury to the cerebellum or its connections, the area of the brain that regulates muscular coordination. This condition can occur from a variety of illnesses, including alcoholism, stroke, tumors, brain degeneration, multiple sclerosis, some drugs, genetic problems, and brain tumors. Doctors base treatment for ataxia based on the underlying reason and its severity. When not so serious, independent living can occur with the use of adaptive equipment like walkers or canes. Additionally, we recommend aerobic activity, physical therapy, occupational therapy, and speech therapy.

What are the Symptoms of Ataxia?

As previously mentioned, ataxia is frequently described as a lack of balance or coordination in bodily motions that are not brought on by muscular weakness. When doing voluntary motor tasks including speaking, moving the eyes, eating, or putting on clothing, ataxia symptoms will display by the child’s walking with an ataxic gait. Ataxia is a symptom of one or more underlying disorders that have an impact on the neurological system.  It is not a distinct disease in and of itself. A repetitive motor activity like gait can make ataxia symptoms fairly obvious. Symptoms of Parkinson’s disease, leg spasticity, or orthopedic anomalies are different from ataxia in terms of how they affect gait.

What Causes Ataxia?

Ataxia can result from abnormalities in various parts of the nervous system.  These include the brain, spinal cord and peripheral nervous system roots and nerves. The nerves link the central nervous system to muscles, skin, and the external world. Cerebellum impairment often links to a patients’ aberrant gait patterns or clumsy hand or arm movements. Two lateral lobes and a center section make up the cerebellum, a spherical structure linked to the brainstem.

The cerebellar cortex, a continuous layer of nerve cells, covers the outside of the cerebellum. The cortex consists of densely linked neurons that organize geometrically in a very predictable way. The majority of the body’s organs as well as other sections of the brain send information to the cerebellar cortex. This information gets transmitted to the cerebellum, which then relays signals to the rest of the brain.  These steps allows for precise and coordinated movements.

Alcohol and Ataxia

An unsteady gait can result from issues with various aspects of the neurological system or the body. However, aberrant walking brought on by cerebellar dysfunction generally has recognized characteristics. The term “broadened base” refers to the abnormally wide base maintained by people who walk with an ataxic gait as a result of cerebellar impairment. They frequently stumble, looking like someone who has had too much alcohol. Given that alcohol impacts the primary nerve cells in the cerebellum, the similarity between ataxia and intoxication is not coincidental. Although acute alcohol intoxication can result in stumbling, that condition goes away over a very short period.

However, frequent exposure to high alcohol dosages can lead to cerebellar neuron degeneration and chronic ataxia. A significant portion of the cerebellar neurons can be damaged from poisons, protracted convulsions, and oxygen deprivation. Gait issues brought on by disorders in other areas of the neurological system, such as the aberrant gait associated with Parkinson’s disease, normal pressure hydrocephalus, or other types of limb spasticity, are not the same as cerebellar ataxia. Because of muscular or orthopedic problems in the hips, legs, or feet, doctors can identify cerebellar ataxia walking.

How to Quantify Ataxia

While doctors can identify ataxic gait symptoms resulting from cerebellar impairment, it’s crucial to better understand them. Ataxic gait frequently exhibits widening of the base of support, increased step variability, cadence, tandem gait errors, and poor balance. Ataxia compensations could involve shuffling and taking shorter steps. The abnormalities brought on by ataxia are often measured using temporal and spatial gait measurements. This enables the quantification of the widening of the base of support through the measurement of stride width as well as the overall variability in step-to-step measurements through the use of a global score, such as the eGVI, or by examining the step-to-step variability of measurements like step length, stride time, stance time, and swing time. Doctors can better treat these conditions by identifying them early with better definitions and knowledge of the gait abnormalities brought on by cerebellar ataxia.

Clinical Features

About 50% of individuals have ataxia of gait. Vertigo, tinnitus, alternating hemiparesis, and paresthesias of the fingers, toes, and corners of the mouth are further symptoms. Vision loss or a sudden loss of consciousness for less than a minute are other symptoms.  Brainstem stroke and cardiac arrhythmia are uncommon but can cause potentially fatal consequences . Usually, neurological problems are followed by a strong, throbbing occipital headache. Less than one-third of cases include nausea and vomiting. Basilar migraine attacks may occur often in children, but with time, the attacks develop into a pattern of typical migraines. Vertigo and ataxia may occur for the patient during occurrences of typical migraines.

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