It's time for another #tweetorial #twittorial!
Today's topic: Functional Gait Disorders
#FunctionalGait #FND #FMD #Gaitdisorders #Ataxia #MovDis #Medstudenttwitter #neuroresidents #neurology #movementdisorders #FNDHope
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#Inconsistency is the variability in gait disorder severity over time.
#incongruency involves a combination of symptoms and sins not seen in organic disorders.
#distractibility
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Identify any abnormal walking pattern: inability to walk in a straight line, scissoring or knee buckling, etc
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- #dystonic, #ataxic, #spastic, #weak, #antalgic, #parkinsonian, and #hemiparetic
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n.neurology.org/content/94/24/…
A detailed list of signs, including videos in the article below:
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Suggestive signs of an ataxic gait:
- variability in the base of support and stride
- inability to walk in straight line (sometimes with excessive arm swing)
- poor balance
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On #functional dystonic gait, abnormal posturing may disappear during casual walk.
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#functional etiology suggested by absence of spasticity, normal reflexes & no weakness
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#Giveaway #weakness is suggestive of #functional etiology
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Functional antalgic gait has an inexplicable variability during dual tasks, tandem gait, walking with eyes closed or backward.
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Inconsistent bradykinesia, rigidity, distractible tremor and incongruent pattern of FOG may suggest a functional etiology.
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Absence of #spasticity, #Giveaway weakness and positive #Hoover sign can be found in #functional etiology. Also, variability during exam is present
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- Casual walk
- Tandem walk
- Romberg test (worsens vestibular, and sensory ataxia)
- Pull test
- Eyes closed
- Walk backwards, dual-task
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- #phenomenology first!
- Look for signs that may suggest functional etiology #distractibility, #inconsistency and #incongruency
- Look for other supportive signs since functional gait disorders are usually accompanied by other functional neurological symptoms.
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link.springer.com/article/10.100…
Inspired in the review: Functional Gait disorders: A great sign-based approach (videos Available)
n.neurology.org/content/94/24/…
This #twittorial is a brief overview with educational/board review purposes. Not intended as medical advise.
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