FDMA FLAP - The first dorsal metacarpal artery (FDMA) flap is used mainly for...
Gait
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Editor's Notes
Normal gait: erect posture, moderately sized steps, arms swing
UNSTEADINESS AND BROAD BASED GAIT- CEREBELLAR, VESTIBULAR, & PROPRIOCEPTIVE DISORDERSVision compensates for proprioceptive lossVestibular disorder- nystagmus & no other cerebellar signsProprioceptive disorder-cerebellar signs may be present & are typically worse when the eyes are closed
Bear in mind, not everyone may be able to walk on their toes or heels-especially the elderly.
Likened to a drunken sailor gait
One of the causes of multiinfarct dementia, in which there are many infarcts and lacunae in the white matter, with relative sparing of the cortex and basal ganglia.
MRI BRAIN/SPINE- MS (PERIVENTRICULAR WHITE MATTER LESIONS OR HIGH SIGNAL INTENSITIES),SPINAL XRAY-LOOK FOR FRACTURE CAUSING MYELOPATHYSPINAL MRI-LOOK FOR CORD COMPRESSION DUE TO TUMOUR, PROLAPSED DISC, INFECTION OR TRAUMACXR/CT THORAX-BRONCHOGENIC CA CAUSING PARANEOPLASTIC SYNDROME LEADING TO CEREBELLAR SYNDROME
FBC-leucocytosis, megaloblastic anemia due to B12 deficiencyESR- raised in inflammatory condition eg: SLE (vasculitis) transverse myelitisSyphilis serology- +ve may indicate myelopathy or tabesdorsalisSerum B12 deficiency subacute combined degeneration of the cord loss of vibration and joint position sense ataxic gaitU & E- severe hypokalaemia can cause muscle weakness, hypocalcaemia cause myopathyPSA- secondary met to spine is the commonest cause of cord compression.Serum Creatinephosphokinase- elevated in many dystrophies/muscle disease
Lumbar puncture elevated granulocytes bacterial meningitis or encephalitis cerebellar syndromeIncreased lactate can occur the presence of cancer of the CNS, multiple sclerosis, traumatic brain injury, cerebral ischemia, brain abscess, hydrocephalus or bacterial meningitis. Changes in total protein content of cerebrospinal fluid- meningitis, neurosyphilis, brain abscesses, subarachnoid hemorrhage, polio or Guillain-Barré syndromeMuscular biopsy-muscular disorders