Neuropathic gait
This abnormal gait is caused by weakness of the muscles in the distal limb due to deterioration of the peripheral nerves providing motor innervation. Weakness of the dorsiflexion of the foot results in foot drop and dragging of the toes during the swing phase.
To prevent the toes from dragging on the floor, the hip and knee excessively flex, creating a “high stepping” gait. Foot drop may, therefore, be caused by L5 radiculopathy, which is generalized polyneuropathy involving multiple nerves, or isolated common peroneal nerve palsy secondary to trauma or compression.
Clinical features which can be associated with a neuropathic gait include:
-Reduced or absent reflexes
-Peripheral vascular disease
-Distal muscle weakness
-Peripheral sensory impairment
One Response
I am surprised that your list of reasons for gait abnormalities did not include normal pressure hydrocephalus. I started involuntarily shuffling my feet and had diminished stride In my early seventies. When I took Anatomy and Physiology in college, the instructor told us that some people with brain injuries could not stride more than 12 inches when walking. In addition to stride changes, I found it increasingly difficult to organize and reason. I couldn’t put together a report for my work. A CT scan revealed a significantly enlarged third ventricle. I had an ETV performed by image-guided surgery to form a drainage path through scar tissue that blocked the flow of CNS in my third ventricle at OHSU in Portland. I got immediate relief and have no gait or mental confusion symptoms for the last 10 years.