Gait instability - what causes it?

50,962 views

Κ. Κωσταβάρας, Νευροχειρουργός (σπονδυλική στήλη)

Published on Dec 18, 2024
About :

Gait instability is a very common symptom, especially in old age. Possible diagnoses have to do with: 1. Neurological Causes Vascular Stroke Brain tumors Hydrocephalus Parkinson's disease Cerebellar ataxia (tumors, alcoholism, hereditary ataxias) Multiple sclerosis Spinal cord (tumors, multiple sclerosis, myelopathy) Lumbar stenosis Radiculopathy (herniated disc) Peripheral neuropathy (e.g. diabetes mellitus, vitamin B12 deficiency) Guillain-Barré syndrome 2. Skeletal Causes Spine (kyphosis, scoliosis) Asymmetry Arthritis (e.g. hip, knee) Foot and ankle disorders Muscle weakness or atrophy 3. Vestibular and Sensory Causes Vestibular system dysfunction (e.g. benign paroxysmal positional vertigo) Loss of proprioception (e.g. neuropathy, myelopathy) Visual disorders (e.g. cataract, macular degeneration) 4. Cardiovascular Causes Orthostatic hypotension Arrhythmias (e.g. atrial fibrillation) Transient ischemic attack (TIA) or carotid stenosis 5. Systemic and Metabolic Causes Hypoglycemia Electrolyte, liver, kidney disorders Thyroid disorder Vitamin D and B12 deficiency Drug side effects (e.g. sedatives, antihypertensives) Intoxication or alcohol withdrawal syndrome 6. Psychogenic and Functional Causes Anxiety or depression affecting balance Conversion disorder or functional gait disorder 7. Age-Related Causes Physiological aging (slower reflexes, muscle weakness) Frailty and sarcopenia Multifactorial instability Lack of exercise

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