Gait Or Balance Issues| Non-Neurological Causes

Requires detailed history to fully understand the pace (acute, subacute, chronic) of events and symptoms which the patient is experiencing. Exam and studies are used to further define the underlying problem.

Your Path

  • Gait or Balance Issues| Non-Neurological Causes

Etiology

  • Illicit drugs
  • Deconditioning
  • Generalized weakness - which can occur with multiple medical disorders (e..g. heart failure, liver disease, chronic kidney disease, advanced lung disease, malignancies, HIV, other infections, anemia, hypo or hyperthyroidism, other endocrinopathies, etc.)
  • Visual or hearing problems
  • Orthostatic blood pressure related (cardiovascular or autonomic etiology)
  • Musculoskeletal disorders - in particular knee, hip, ankle osteoarthritis or other processes contributing to instability when standing/walking
  • Medication side effects
  • Vitamin D deficiency in the elderly (causing weakness)
  • Cognitive disorders (dementia, delirium)
  • Combinations of any of above or coupled with primary neurological causes, in partic w/older patients

Risk Factors

  • Older age (higher risk for most of above issues)

Symptoms

  • Imbalance
  • Weakness in general
  • Falls - and if so, events that surround them as well as sequelae
  • DIzziness - and if so, precipitants, more detailed description

Physical Exam Findings

  • Vital signs might reflect orthostasis, if that's contributing
  • Vision and hearing screening test
  • Might look overall frail, if that's contributing, including overall weakness
  • Observe patient getting up and walking (providing support if needed to prevent falls)
  • Musculoskeletal findings, including: arthritis, joint abnormalities, antalgic (limping) gait, other issues that impact ability to bear weight/stand/walk
  • Neurological assessment: evidence muscle, neuromuscular, PNS or CNS processes

Tests