Система Orphus

Symptoms of disease - violation of equilibrium

Violation of the equilibrium - short-term or permanent inability to manage the position of the body in space, is manifested unstable gait, unexpected failures, dancing, coordination disorders.

Balance disorders often coincide with dizziness, nausea, harassing vomiting, General weakness.


Usually they are caused by the changes of the vestibular apparatus, intoxications (alcoholism, food), traumatic and other lesions of the brain and spinal cord diseases of the inner ear.



Which diseases there is violation of equilibrium

Hemiparesis

In the patient with expressed hemiparesis when standing and walking will be bringing in my shoulder flexion of the elbow, wrist joints and fingers, and in the leg - extension in the hip, knee and ankle joints. Arise shortness of flexion of the hip joint and bending the back of the ankle joint. Paretic limb be moved forward so that the foot barely touches the floor. The foot is held with difficulty and describes a semi-circle, first in the side of the torso, and then to him, making a rotary motion. Often leg movement causes a slight slope of the upper half of the body in the opposite direction. Movement paretic hand while walking is usually limited. The loss of a wave of the hand when walking can serve as an early indicator of the progression of the hemiparesis. In a patient with moderate hemiparesis have the same disorder, but they are less expressed. In this case, the decrease in the amplitude hands while walking can be combined with a barely noticeable arched movement of his legs, without the expressed stiffness or weakness in the affected limbs.

Paraparesis

In diseases of the spinal cord, the motor way, going to the muscles of the lower extremities, there are characteristic changes of the gait, due to a combination of spasticity and weakness in the legs. Walking requires a certain voltage and is carried out with the help of slow rigid movements in the hip and knee joints. The legs are usually tense, slightly bent in the hip and knee joints and stored in the hip joint. In some patients, the feet can totter at every step and reminded those of a pair of scissors. Step usually regular and short, a patient may sway from side to side, trying to compensate for this stiffness in the legs. Feet commit arched movement, feet shuffling on the floor, soles of shoes such patients are erased in his socks.

Parkinsonism

In Parkinson's disease develop characteristic posture and gait. In a grave condition in patients note flexion position, with a bend forward in the thoracic region of the spine, tilting his head down, bent at the elbows and hands slightly bent in the hip and knee joints of the feet. The patient sits or stands still, note the poverty facial expressions, rare blinking, permanent automatic movement in the extremities. The patient rarely crosses his legs or otherwise fits the position of the body, when sitting on a chair. Though they remain motionless, often celebrated tremor of the fingers and wrists with a frequency of 4-5 reductions in 1 s. In some patients, tremor applies to the elbows and shoulders. In the later stages can celebrate salivation and tremors of the lower jaw. The patient slowly begins to walk. During the walk body leans forward, his hands are immobile or even more bent and stay ahead of the body. There are no waving of hands while walking. When moving forward legs remain bent in the hip, knee and ankle joints. It's characteristic that the steps are so short that his feet were dragging on the floor, and the soles of shuffling and hit the floor. If progress continues, the steps become quicker and more patient in the absence of support may fall (mincing gait). If the patient push forward or backward, the compensatory flexion and extensor movement of the body will not occur and the patient will be forced to make a number of propulsive steps. Patients with Parkinson? s disease are experiencing significant difficulties when getting up from a chair or the beginning of a movement after the motionless state. The patient begins to walking with a few small steps, then the step length increases.

The defeat of the cerebellum

The defeat of the cerebellum and its connections lead to significant difficulties in the condition of the patient and walking without assistance. The difficulties are compounded when you try to walk the narrow line. Patients usually stand with his legs wide apart, of itself, standing can cause problems, big sweeping movement of the body back and forth. Attempt to put feet together leads to teeter or fall. Instability is stored in open and closed eyes. The patient walks cautiously, making the steps of varying length and swaying from side to side; complains of a violation of equilibrium, he was afraid to walk without support and rely on any objects, such as a bed or chair, moving carefully between them. Often a simple touch on the wall or some object allows you to walk quite confidently. In the case of moderate disturbance gait difficulties arise when you try to go in a straight line. This leads to the loss of stability, the patient is forced to make a sharp move one foot to the side to prevent the fall. When unilateral lesions of the cerebellum patient falls in the direction of destruction.

When defeat is limited to Central entities of the cerebellum (worm), as, for example, when alcohol cerebellar degeneration, the change of posture and gait may occur without the other cerebellar disorders such as ataxia or nystagmus.

Sensitive ataxia

Patients with sensitive Friedreich's do not feel the position of the legs, so have a problem as when standing, so when walking; usually they are with legs wide apart; can keep the balance, if you ask them to put your feet together and not to close his eyes, but with his eyes closed they teeter and often fall (positive symptom Romberga). Sample Romberga is impossible to hold, if the patient even with open eyes are not in a position to put his feet together, as is often the case when lesions of the cerebellum.

Patients with sensitive Friedreich's widely straddle when walking, raise them higher than is necessary, and impulsively swaying back and forth. The steps vary by the length of the foot emit a characteristic flapping sounds in contact with the floor. The patient is usually slightly bend your torso in the hip joint, while walking often uses a stick to support. The defects of sight aggravated breach of the gait. Often patients lose their stability and fall at washing, because, closing his eyes, they temporarily lose the visual control.

Cerebral palsy

It refers to many different motor disorders, most of which is due to hypoxia or ischemia damage of the Central nervous system in the perinatal period. The severity of the change of gait is very different depending on the nature and severity of the lesion. Lungs limited lesions may cause increase of tendon reflexes and symptom Babinsky with moderate equinovarus foot deformation without the Express violation of the gait. More severe and extensive lesions, as a rule, lead to bilateral hemiparesis. There are changes in POS and gait, characteristic for paraparesis; the hands of the allocated in the shoulders and bent at the elbows and wrists.

Cerebral palsy causes in patients with motor disorders that can lead to the change of gait. Often develops atetoz, characterized by slow or moderately fast serpentine movements of the arms and legs, changing postures from the extreme degree of flexion and supination to Express extension and pronation. When walking in these patients experience involuntary movements of the limbs, accompanied by rotational movements of the neck or a grimace on his face. Hands are usually bent and legs stretched out, however, this asymmetry of limbs can be revealed only in the monitoring of patients. For example, one hand can be bent and supinate, and the other pulled out and pronated. Asymmetric position of the limbs usually occurs when turning your head to the side. As a rule, at the turn of the chin in one of the hand on this side of the unbent, and the other arm bent.

Chorea

In patients with choreiform hyperkinesia often there are infringements of gait. Chorea is likely to develop in children with the Sydenham's chorea in adults with the Huntington's disease and in rare cases, patients with Parkinson's disease, receiving excessive doses of dopamine antagonists. Choreiform giperkinez is manifested rapid movements of the muscles of face, trunk, neck, and extremities. Arise flexion, extensor and rotational movements of the neck, appear grimace on his face, rotary movement of the torso and limbs, the movement of the fingers become fast, as during the game on the piano. Often in the early Huntington appear flexion and extensor movement in the hip joints, so that the impression is created that the patient is constantly crosses and straightens his legs. The patient may involuntarily mothers frown, looking angrily or smile. When walking trochu giperkinez is usually amplified. Sudden jerky movement of the pelvis forward and to the sides and fast movements of the trunk and extremities give rise to dance gait. The steps are usually uneven, the patient is difficult to walk in a straight line. Movement speed varies depending on the speed and amplitude of each step.

Dystonia

Dystonia is called involuntary change poses and movements, developing in children (deform muscular dystonia, or torsion dystonia) and in adults (late dystonia). It may occur sporadically, have hereditary or appear as part of another of the pathological process, for example, Wilson disease. When deformed muscular dystonia, usually manifesting in childhood, the first symptom is often a violation of the gait. Typical is the gait with several inverted stacked, when the patient puts the weight on the outer edge of the foot. With the progression of the disease these difficulties are compounded and often develop violations of POS: elevated position of one arm and thigh, the curvature of the body and excessive bending in wrist joint and the fingers of the hand. Alternating tension in the muscles of the torso and limbs impede walking, in some cases, may develop torticollis, the curvature of the pelvis, lordosis and scoliosis. In the most severe cases, patients lose the ability to move around. Later dystonia, as a rule, leads to a similar increase of motor disorders.

Muscular dystrophy

Pronounced weakness of the muscles of the torso and proximal feet leads to the theme-changes POS and gait. When you try to stand up from sitting position sick leans forward, bend your torso in the hip joints, puts his hands on his knees and pushes the torso up, his hands resting on her thighs. In a standing position note the strong degree of lordosis of the lumbar spine and protrusion of the stomach due to the weakness of the abdominal and paravertebral muscles. The patient walks with legs wide apart, the weakness of the gluteal muscles leads to the development of the «duck walk». Shoulders usually lean forward, so that when walking, you can see the movement of the wings of the blades.

The defeat of the frontal lobe of the

At the bilateral defeat of the frontal lobes arises characteristic change of gait, often combined with dementia and symptoms facilitate the frontal lobe, such as grasping, suckling and proboscis reflexes. The patient is standing with legs wide apart and makes the first step only after a long delay. After these doubts patient is very small shuffle steps, then a few steps moderate amplitude, after which the patient freezes, unable to continue, then the cycle repeats itself. Such patients usually does not reveal the muscle weakness, changes of tendon reflexes, sensitivity or symptoms of Babinsky. Usually, the patient can perform separate movements necessary for a walk, if you ask him play the motion of walking in a position lying on a back. Violation of gait in the defeat of the frontal lobes is a kind of apraxia, i.e. violations of the execution of motor functions in the absence of a weakness of the muscles involved in the movement.

Normotensive hydrocephalus

Normotensive hydrocephalus (STG) is called the defeat, characterized by dementia, apraxia and incontinence. Axial tomography reveals the expansion of the ventricles of the brain, the expansion of the corner of corpus callosum and the lack of filling stem spaces of the brain hemispheres cerebrospinal fluid. With the introduction of radioactive isotopes in subarachnoid space of the lumbar region of the spine watching pathological casting isotope in the ventricular system and the inadequate distribution of it in hemispheric subarachnoid space.

Gait when STG such as abscesses in apraxia due to the destruction of the frontal lobes, it consists of a number of small, shuffling steps, creating an impression that my feet stick to the floor. Hampered by the beginning of the movement, occurs slow moderate angular misalignment in the hip, knee and ankle joints, ill just raises a foot above the floor, as if slipping them on the floor. There is a prolonged contraction of muscles of the legs, the effect of which is to overcome the force of gravity, and low activity of the calf muscles. Change of gait in the STG is, apparently, the result of a breach of the frontal lobes. About half of the patients with STG gait improved after the operation of shunting of cerebral spinal fluid in the ventricles of the brain in the venous system.

The ageing of an organism

With the age of the developing certain change of gait and have difficulty with holding the balance. The elderly upper part of his body slightly forward, shoulders going down, his knees bent, reduced the scope of hands when walking, step becomes shorter. In older women develop a slouching gait. Gait disturbance and sustainability predispose older people to fall.

The defeat peripheral motoneurons

The defeat of the peripheral motor neurons or nerve leads to the appearance of weakness in the distal extremities, sag foot. When lesions of the peripheral motor neurons weakness in the extremities develops in combination with fasciculations and atrophy of the muscles. The patient, as a rule, can not bend the stack of back and compensates for this raising knees higher than usual, which leads to steppage. If the weakness of the proximal muscle develops slouching gait.

Gait disturbance hysterical Genesis

Gait disturbance in hysteria usually arise in conjunction with hysterical paralysis of one or more limbs. Gait usual pretentious, very typical for hysteria and easily distinguishable from all other changes in gait, emerging as a result of organic lesions. In some cases, gait disturbance of different etiology may have a similar manifestation, that makes it very difficult to diagnose. Gait disturbance of hysteria may occur regardless of sex and age of the patients.

When hysterical of hemiplegia patient drags the affected limb on the earth, not relying on it. At times he can move paretic foot forward and build on it. Hand on the affected side of the often remains sluggish, hanging without movements along the body, but is not in the folded condition, usually characteristic of hemiplegia of organic origin. In patients with hysterical hemiparesis weakness manifests itself in the form of so-called pasture topping.



Which doctor should I contact if there is a violation of equilibrium

  • Neurologist


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Do you feel disrupted equilibrium? You should be very careful approach to your health in general. People pay not enough attention to the symptoms of the disease and don't realize that these diseases can be critically dangerous. There are many diseases that in the beginning didn't manifest in our body, but in the end it turns out, unfortunately, it have already been treated too late. Every disease has its own specific features typical symptoms - called symptoms of the disease. Definition of symptoms is the first step in the diagnosis of diseases in general. You just need a few times a year to be screened by a doctor, not only to prevent a terrible disease, but also to maintain a healthy spirit in a body and the organism in general.

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