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Gait and Balance Dysfunction in Adults.

Salil Manek1, Mark F. Lew

  • 1*Division of Movement Disorders, Department of Neurology, University of Southern California Healthcare Consultant Center, 1510 San Pablo Street, Suite 268, Los Angeles, CA 90033, USA. mlew@surgery.usc.edu

Current Treatment Options in Neurology
|March 12, 2003
PubMed
Summary

Diagnosing adult gait dysfunction requires careful evaluation due to its complexity. Identifying specific causes like Parkinsonism, cerebellar ataxias, or gluten sensitivity allows for targeted treatments and improved patient outcomes.

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Area of Science:

  • Neurology
  • Gait Disorders
  • Movement Disorders

Background:

  • Gait dysfunction in adults is complex and multifactorial, often complicated by comorbidities in elderly patients.
  • Accurate diagnosis relies on thorough history and physical examination to guide therapeutic decisions.
  • Parkinsonism, cerebellar ataxias, and cortical myoclonus are key conditions to consider in adult gait disturbances.

Purpose of the Study:

  • To review the diagnostic challenges and therapeutic strategies for various causes of adult gait dysfunction.
  • To highlight the importance of identifying specific conditions like normal pressure hydrocephalus, gluten sensitivity, and paraneoplastic ataxias.
  • To discuss recent advancements in managing gait disorders, including deep brain stimulation and external cueing strategies.

Main Methods:

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  • Review of clinical presentations and diagnostic approaches for common gait disorders.
  • Discussion of pharmacological and non-pharmacological treatment options.
  • Overview of emerging therapeutic interventions such as deep brain stimulation and physical therapy techniques.

Main Results:

  • Thorough evaluation can identify reversible causes of Parkinsonism like normal pressure hydrocephalus.
  • Gluten sensitivity and paraneoplastic ataxias are important, treatable causes of cerebellar ataxia.
  • Subthalamic nucleus deep brain stimulation offers an option for advanced Parkinson's disease management.
  • Levetiracetam is effective for cortical myoclonus.

Conclusions:

  • Accurate diagnosis of adult gait dysfunction is achievable through systematic clinical assessment.
  • Targeted treatments, including dietary changes, physical therapy, and advanced neurosurgical interventions, can significantly improve outcomes.
  • Understanding motor control and utilizing external cues are vital for managing gait freezing.