Rationale

Neurologic abnormalities of gait can result from disorders affecting several levels of the nervous system. The type of abnormality observed clinically often indicates the site affected.

Causal Conditions

(list not exhaustive)

1. Cerebellar ataxia

   1. Tumour

   2. Vascular

   3. Hereditary

   4. Multiple sclerosis

   5. Drugs

   6. Alcohol

2. Sensory ataxia

   1. Vestibular

   2. Proprioceptive

   3. Visual

3. Other movement disorders

   1. Parkinson disease

   2. Other central nervous system disorders (e.g., cerebral)

Key Objectives

Given a patient with a gait disturbance, the candidate will distinguish ataxia from other irregularities. The candidate will determine localization, etiology, outcome, and complications, and will initiate an appropriate management plan.

Enabling Objectives

Given a patient with a gait disturbance, the candidate will

1. list and interpret critical findings, including those derived from an appropriate history and physical examination aimed at differentiating between ataxia and other causes of gait disturbance, and at establishing the localization and cause;

2. list and interpret critical investigations, including appropriate laboratory and diagnostic imaging investigations based on clinical findings; and

3. construct an effective initial management plan, including determining whether specific management or specialized care is required.