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Semin Neurol 2013; 33(03): 270-275
DOI: 10.1055/s-0033-1354601
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Causes of Imbalance and Abnormal Gait That May Be Misdiagnosed

Holly A. Shill
1   Christopher Center for Parkinson Research, Banner Sun Health Research Institute, Sun City, Arizona
,
Terry D. Fife
2   Department of Neurology, Barrow Neurological Institute, University of Arizona College of Medicine, Phoenix, Arizona
› Author Affiliations
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Publication History

Publication Date:
21 September 2013 (online)

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Abstract

Disorders of gait and balance are common in medicine and often lead to referral for neurologic evaluation. Because the maintenance of balance and normal gait are mediated by complex neurologic pathways as well as musculoskeletal, metabolic, and behavioral considerations, the list of possible contributing causes is very large. Much of the time, the history and neurologic examination reveal the underlying cause or causes. There are instances, however, when there are limited neurologic findings, as well as no structural abnormalities on brain or spine magnetic resonance imaging studies to explain the imbalance or gait difficulty. In this article, selected disorders that may be overlooked in the neurologic examination and imaging studies are reviewed. Possible causes of imbalance include occult drug-induced ataxia, autoimmune ataxia, ataxia associated with tremor, bilateral vestibular hypofunction, and spastic or dystonic gait disorders with normal imaging.

Keywords

Segawa's disease - gait difficulty - imbalance - ataxia - gluten ataxia - bilateral vestibular loss - essential tremor
 

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