Department of Neurology, Mayo Clinic, Jacksonville, FL 32224, USA.
Semin Neurol. 2011 Feb;31(1):78-84. doi: 10.1055/s-0031-1271309. Epub 2011 Feb 14.
Gait and station disorders are among the most common reasons patients seek outpatient neurologic consultation. A careful assessment of gait and station provides the clinician with an overview of the integrity of a patient's central and peripheral nervous systems. Therefore, clinicians may consider performing a gait and station examination as the prelude to their formal neurologic examination of the patient, regardless of their chief complaint, to gain insight into which areas of the remainder of the neurologic examination they should particularly focus on, to localize the patient's neurologic dysfunction. In this review, the author describes how a structured gait and station examination may be performed in the ambulatory setting, without any special equipment. Then, the precise mechanics of each component of normal gait and station are discussed, so that the potential localizations and significance of abnormalities, which may occur during various phases of the gait cycle, can be highlighted. In particular, some less common findings are emphasized, which may be mistaken as psychogenic in etiology.
步态和站立障碍是患者寻求门诊神经科就诊的最常见原因之一。对步态和站立的仔细评估为临床医生提供了患者中枢和周围神经系统完整性的概述。因此,无论患者的主要主诉如何,临床医生都可以考虑进行步态和站立检查作为其对患者进行正式神经科检查的前奏,以深入了解他们应该特别关注神经科检查的哪些其他方面,以定位患者的神经功能障碍。在这篇综述中,作者描述了如何在没有任何特殊设备的情况下,在门诊环境中进行结构化的步态和站立检查。然后,讨论了正常步态和站立的每个组成部分的精确力学,以便突出在步态周期的各个阶段可能出现的异常的潜在定位和意义。特别是,强调了一些不太常见的发现,这些发现可能会被误认为是病因上的精神性的。