SENSORY GAIT
A Sensory Gait, which also refers to sensory ataxia, results from a lack of sensory input. Sensory Ataxia normally controls movement. Doctors describe ataxia as a physical reduction of voluntary muscle coordination causing a sensory loss and preventing walking properly.
At Medical City Children’s Orthopedics and Spine Specialists, our expert Sensory Gait Doctors are dedicated to diagnosing and treating children and ensuring comprehensive care tailored to each patient’s needs. With advanced techniques and a compassionate approach, our team is here to diagnose, treat and care for children suffering from Sensory Gait.
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Sensory Gait
A kind of ataxia known as sensory ataxia results from a lack of sensory input that normally controls movement. Doctors describe ataxia as a physical reduction of voluntary muscle coordination. So, Sensory Gait is the sensory loss of where various body parts are situated and the ground. The sensory loss causes a lack of coordination between muscle movements, and therefore, an unusual gait. Unsteady walking occurs with sensory ataxia, which can also make it difficult to balance when it’s dark outside. Also, when one’s eyes are closed like washing your child’s hair in the shower. Patients with sensory ataxia walk with a high-stepping gait or a feet-slapping stride because of motor impairment. It’s possible for sensory neuronopathy to affect the arms and cause erratically moving fingers on outstretched hands with eyes closed.
Sensory Ataxia results from damage to the nerves. Those nerves carry signals from the position sensors in the muscles and joints to the brain’s movement control center. When patients are able to address the issue, their coordination is nearly normal. Nevertheless, when their eyes are closed, their coordination noticeably deteriorates. This shows how sensory ataxia differs from cerebellar ataxia.
Classic Features of Sensory Gait
A hallmark of sensory ataxia is a high-stepping, slapping gait. Patients often lift their knees higher than normal and bring their feet down hard, making a distinctive slapping sound. This audible feedback helps compensate for lost sensation, especially when vision is limited with dim lighting or with closed eyes. In severe cases, like tabes dorsalis, the knees may hyperextend due to a profound loss of proprioception. Patients often adopt a stooped posture so they can watch their feet more closely for visual feedback.
Slapping the floor with the feet isn’t just a quirk; it’s a practical adaptation. By listening to their footsteps, individuals with sensory ataxia use sound as a backup sense for balance and coordination. Sensory ataxia affects more than just walking. When the arms are involved, patients may show irregular movements when asked to hold their hands out. When a patient closes their eyes, they will have the same loss of position sense that disrupts their gait.
Romberg’s sign is frequently seen in patients with sensory ataxia. When they close their eyes in the shower or close their eyes, they frequently complain of losing their footing. When the dorsal columns of the spinal cord are damaged, as in tabes dorsalis, sensory ataxia develops. It is also present in sensory peripheral neuropathies.
QUESTIONS AND ANSWERS
What is sensory ataxia, and what causes it in children?
Sensory ataxia is a form of ataxia that results from damage to the sensory nerves, particularly those responsible for proprioception (awareness of body position) and coordination. In children, sensory ataxia can be caused by various factors, including genetic disorders, neurological conditions, or certain infections. It’s crucial for the doctor to conduct a thorough evaluation, including neurological examinations and possibly imaging studies, to determine the underlying cause.
What are the treatment options for sensory ataxia in children, and how can we help our child manage their symptoms?
Treatment for sensory ataxia in children often involves addressing the underlying cause, if known, and focusing on rehabilitation to improve coordination and balance. Physical therapy, occupational therapy, and assistive devices may be recommended to help the child cope with the challenges of sensory ataxia. Parents can work closely with healthcare professionals to create a personalized plan that includes exercises and activities to enhance proprioception and overall motor function. Creating a supportive and safe environment at home is essential.
What is the long-term outlook for my child with sensory ataxia, and will they be able to lead a normal life?
The long-term outlook for a child with sensory ataxia depends on the severity of the condition, the underlying cause, and the effectiveness of interventions. While some cases may present ongoing challenges, many children with sensory ataxia can improve with appropriate treatment and support. Regular follow-up with healthcare providers is essential to monitor progress, make necessary adjustments to the treatment plan, and address any new concerns. With early intervention and a comprehensive approach to care, many children with sensory ataxia can lead fulfilling lives.
Parents should seek the guidance of healthcare professionals, including pediatric neurologists and rehabilitation specialists, to address their specific concerns about a child with sensory ataxia. These specialists can provide a more detailed assessment, discuss treatment options, and offer support to help manage the child’s condition.
Walking differently can be a medical indication that something is wrong. Make an appointment with one of our pediatric orthopedists to ensure everything is fine.
Why Do Patients with Sensory Ataxia Slap Their Feet?
In cases like tabetic gait, you might notice patients purposefully slapping their feet on the ground as they walk. This isn’t just an odd habit; it’s actually the body’s clever way of compensating for lost sensation. When there’s significant proprioceptive impairment, especially in the legs, the brain has trouble figuring out exactly where the feet are without visual clues.
By forcefully bringing the feet down, patients create a noticeable sound and sensation. This extra auditory and vibrational feedback helps them confirm that their feet have made contact with the ground. As a result, the “foot slapping” serves as a substitute for the lost sensory input they would normally get through healthy nerves. Overall posture may also change—individuals may walk with straightened knees or even a stooped stance, all to keep the feet in sight and maintain balance.
The Most Common Causes
- Neuropathy: Neuropathy is a condition that damages nerves. Peripheral neuropathy, which is damage to nerves, is the most common cause of sensory gait. A variety of factors, including diabetes, alcoholism, and vitamin deficiencies, can cause peripheral neuropathy.
- Spinal cord injury: A spinal cord injury can damage the nerves that carry sensory information from the limbs to the brain. This can lead to sensory gait in the legs.
- Multiple sclerosis: Multiple sclerosis is an autoimmune disease that attacks the myelin sheath, which is the protective covering of nerve fibers. This can damage the nerves that carry sensory information from the limbs to the brain.
- Cerebellar ataxia: Cerebellar ataxia is a condition that affects the cerebellum, which is a part of the brain that helps to coordinate movement. Cerebellar ataxia can lead to sensory gait in the arms and legs.
Additional Causes Include
Damage to spinal cord nerves or nerves that supply the extremities, such as the feet and legs, is the usual cause of sensory ataxia. Spinal cord compression, exposure to poisons like lead, mercury, and arsenic, as well as a variety of other ailments, can cause loss of feeling in the feet, hands, and torso due to nerve injury.
- Brain hemorrhage
- Cerebral palsy
- Diabetes mellitus
- Friedreich ataxia
- Guillain-barré syndrome
- Head trauma
- Hereditary sensorimotor neuropathy type 3
- Peripheral neuropathies
- Porphyria
- Tabes dorsalis
- Toxic reaction
- Vitamin E deficiency
- Vitamin b-12 deficiency
How Does Tabes Dorsalis Affect Gait and Posture?
Tabes dorsalis is a degenerative neurological condition that can significantly alter both gait and posture. Children (and adults) affected by tabes dorsalis often lose the ability to sense the position of their legs in space due to severe impairment of proprioception. As a result, they may walk with their knees pushed backward (hyperextended) and adopt a stooped posture as they constantly look down to keep visual track of their feet.
To compensate for diminished sensation, individuals frequently slap their feet forcefully against the ground. This creates a distinct sound and sensation, which serves as a helpful cue for foot placement and balance. These adjustments, while adaptive, lead to a gait that appears uncoordinated and can increase the risk of both discomfort and falls.
Sensory Gait Symptoms
As a result of sensory ataxia, which causes the feet and legs to lose their feeling, patients acquire an uneven stride that doctors refer to as “walking on pillows.” With the foot striking the ground forcefully with each step, leg and foot discomfort might potentially occur. Typically, the patient walks with a downward gaze and slaps the ground with his or her feet. Uneven, rocky paths become problematic for balance and for falling.
Because the brain relies more heavily on visual information to determine body position, a person’s senses need to know where the feet and legs are positioned in the environment. Unsteadiness and imbalance are more noticeable when the eyes are closed or when night occurs for those with Sensory Ataxia. A Romberg test becomes positive when your child loses his or her balance when they close their eyes during the test. Doctors see loss of balance with increased swaying of the body, foot movement, and then falling. Additionally, those who have sensory ataxia will exhibit a positive Romberg test.
When the dorsal columns of the spinal cord are severely damaged by syphilis, patients with Tabes Dorsalis who also have severe sensory ataxia will have a high Romberg test. In research, healthy individuals and more than half of the patients with cerebellar ataxia stood for 60 seconds with their eyes closed. Patients with sensory ataxia barely managed 10 seconds before starting to fall over.
Sensory Gait Treatment
Treatment for sensory ataxia focuses on reducing symptoms, slowing the progression of nerve damage, and reducing the risk of falling. If the doctors can identify a cause, treatments will, whenever practical, begin to target the root cause. For instance, vitamin B12 insufficiency is controlled by maintaining strict glucose control. However, diabetic neuropathy is treated by vitamin B12 supplementation (usually starting with injections and then moving to oral). Physical therapy frequently helps patients with neuropathy balance and gait, regardless of the underlying reason. Doctors may recommend an occupational therapist as part of the treatment. These professionals can make changes to the home environment and offer suggestions on how to make everyday tasks simpler. If necessary, your doctor may prescribe specialized drugs to treat nerve pain. Doctors may also recommend balancing therapy, the use of mobility aids, and other appropriate interventions.
Choosing Medical City Children’s Orthopedics and Spine Specialists
Always consult with your doctor if your child begins to walk differently. If you come to one of our Medical City Children’s Orthopedics & Spine Specialists offices in Arlington, Dallas, Flower Mound, Frisco, and McKinney, TX, our pediatric orthopedic doctors will examine your child and recommend the best treatment option to repair the problem and get your child back playing.
As previously mentioned, our doctors at the Medical City Children’s Orthopedics and Spine Specialists will examine your child and understand the reasons for an unusual gait. At that point, the doctor will prepare an individualized treatment plan for your child if he finds the cause of the unusual gait. After correcting the problem, your child will resume his or her favorite activities. For athletes, it may take up to a year before they can resume their sport.
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Library of Science: Gait Ataxia
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