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Gait imbalance

MedGen UID:
373028
Concept ID:
C1836150
Finding
Synonyms: Abnormality of balance; Abnormality of equilibrium; Imbalanced walk
 
HPO: HP:0002141

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • Gait imbalance

Conditions with this feature

Benign paroxysmal positional vertigo
MedGen UID:
57837
Concept ID:
C0155502
Disease or Syndrome
Benign recurrent vertigo (BRV), also known as benign paroxysmal positional vertigo (BPPV), is a common disorder affecting up to 2% of the adult population. The majority of individuals with chronic recurrent vertigo have no identifiable cause, no progression of the disorder, and no other neurologic or auditory signs. Many families have multiple affected individuals, suggesting familial transmission of the disorder with moderate to high penetrance (summary by Lee et al., 2006).
Williams syndrome
MedGen UID:
59799
Concept ID:
C0175702
Disease or Syndrome
Williams syndrome (WS) is characterized by cardiovascular disease (elastin arteriopathy, peripheral pulmonary stenosis, supravalvar aortic stenosis, hypertension), distinctive facies, connective tissue abnormalities, intellectual disability (usually mild), a specific cognitive profile, unique personality characteristics, growth abnormalities, and endocrine abnormalities (hypercalcemia, hypercalciuria, hypothyroidism, and early puberty). Feeding difficulties often lead to poor weight gain in infancy. Hypotonia and hyperextensible joints can result in delayed attainment of motor milestones.
Brown-Vialetto-van Laere syndrome 1
MedGen UID:
163239
Concept ID:
C0796274
Disease or Syndrome
Brown-Vialetto-Van Laere syndrome is a rare autosomal recessive neurologic disorder characterized by sensorineural hearing loss and a variety of cranial nerve palsies, usually involving the motor components of the seventh and ninth to twelfth (more rarely the third, fifth, and sixth) cranial nerves. Spinal motor nerves and, less commonly, upper motor neurons are sometimes affected, giving a picture resembling amyotrophic lateral sclerosis (ALS; 105400). The onset of the disease is usually in the second decade, but earlier and later onset have been reported. Hearing loss tends to precede the onset of neurologic signs, mostly progressive muscle weakness causing respiratory compromise. However, patients with very early onset may present with bulbar palsy and may not develop hearing loss until later. The symptoms, severity, and disease duration are variable (summary by Green et al., 2010). Genetic Heterogeneity of Brown-Vialetto-Van Laere Syndrome See also BVVLS2 (614707), caused by mutation in the SLC52A2 gene (607882) on chromosome 8q.
Supranuclear palsy, progressive, 2
MedGen UID:
324446
Concept ID:
C1836148
Disease or Syndrome
Spinocerebellar ataxia type 11
MedGen UID:
346799
Concept ID:
C1858351
Disease or Syndrome
Spinocerebellar ataxia type 11 (SCA11) is characterized by progressive cerebellar ataxia and abnormal eye signs (jerky pursuit, horizontal and vertical nystagmus). Pyramidal features are seen on occasion. Peripheral neuropathy and dystonia are rare. Six families have been reported to date, one each from the UK, Pakistan, France, Germany, Denmark, and China. Age of onset ranged from early childhood to the mid-40s. Life span is thought to be normal.
Bardet-Biedl syndrome 1
MedGen UID:
422452
Concept ID:
C2936862
Disease or Syndrome
Bardet-Biedl syndrome is an autosomal recessive and genetically heterogeneous ciliopathy characterized by retinitis pigmentosa, obesity, kidney dysfunction, polydactyly, behavioral dysfunction, and hypogonadism (summary by Beales et al., 1999). Eight proteins implicated in the disorder assemble to form the BBSome, a stable complex involved in signaling receptor trafficking to and from cilia (summary by Scheidecker et al., 2014). Genetic Heterogeneity of Bardet-Biedl Syndrome BBS2 (615981) is caused by mutation in a gene on 16q13 (606151); BBS3 (600151), by mutation in the ARL6 gene on 3q11 (608845); BBS4 (615982), by mutation in a gene on 15q22 (600374); BBS5 (615983), by mutation in a gene on 2q31 (603650); BBS6 (605231), by mutation in the MKKS gene on 20p12 (604896); BBS7 (615984), by mutation in a gene on 4q27 (607590); BBS8 (615985), by mutation in the TTC8 gene on 14q32 (608132); BBS9 (615986), by mutation in a gene on 7p14 (607968); BBS10 (615987), by mutation in a gene on 12q21 (610148); BBS11 (615988), by mutation in the TRIM32 gene on 9q33 (602290); BBS12 (615989), by mutation in a gene on 4q27 (610683); BBS13 (615990), by mutation in the MKS1 gene (609883) on 17q23; BBS14 (615991), by mutation in the CEP290 gene (610142) on 12q21, BBS15 (615992), by mutation in the WDPCP gene (613580) on 2p15; BBS16 (615993), by mutation in the SDCCAG8 gene (613524) on 1q43; BBS17 (615994), by mutation in the LZTFL1 gene (606568) on 3p21; BBS18 (615995), by mutation in the BBIP1 gene (613605) on 10q25; BBS19 (615996), by mutation in the IFT27 gene (615870) on 22q12; BBS20 (619471), by mutation in the IFT172 gene (607386) on 9p21; BBS21 (617406), by mutation in the CFAP418 gene (614477) on 8q22; and BBS22 (617119), by mutation in the IFT74 gene (608040) on 9p21. The CCDC28B gene (610162) modifies the expression of BBS phenotypes in patients who have mutations in other genes. Mutations in MKS1, MKS3 (TMEM67; 609884), and C2ORF86 also modify the expression of BBS phenotypes in patients who have mutations in other genes. Although BBS had originally been thought to be a recessive disorder, Katsanis et al. (2001) demonstrated that clinical manifestation of some forms of Bardet-Biedl syndrome requires recessive mutations in 1 of the 6 loci plus an additional mutation in a second locus. While Katsanis et al. (2001) called this 'triallelic inheritance,' Burghes et al. (2001) suggested the term 'recessive inheritance with a modifier of penetrance.' Mykytyn et al. (2002) found no evidence of involvement of the common BBS1 mutation in triallelic inheritance. However, Fan et al. (2004) found heterozygosity in a mutation of the BBS3 gene (608845.0002) as an apparent modifier of the expression of homozygosity of the met390-to-arg mutation in the BBS1 gene (209901.0001). Allelic disorders include nonsyndromic forms of retinitis pigmentosa: RP51 (613464), caused by TTC8 mutation, and RP55 (613575), caused by ARL6 mutation.
Autosomal dominant intellectual disability-craniofacial anomalies-cardiac defects syndrome
MedGen UID:
903767
Concept ID:
C4225396
Disease or Syndrome
Arboleda-Tham syndrome (ARTHS) is an autosomal dominant disorder with the core features of impaired intellectual development, speech delay, microcephaly, cardiac anomalies, and gastrointestinal complications (summary by Kennedy et al., 2019).
Intellectual disability, X-linked, syndromic 33
MedGen UID:
895979
Concept ID:
C4225418
Disease or Syndrome
X-linked syndromic intellectual developmental disorder-33 (MRXS33) is an X-linked recessive neurodevelopmental disorder characterized by delayed psychomotor development, intellectual disability, and characteristic facial features (summary by O'Rawe et al., 2015).
Sifrim-Hitz-Weiss syndrome
MedGen UID:
934655
Concept ID:
C4310688
Disease or Syndrome
CHD4 neurodevelopmental disorder (CHD4-NDD) is associated with developmental delay, speech delay, and usually mild-to-moderate intellectual disability. Variability between individuals with CHD4-NDD is significant, and a few have normal intelligence. Other manifestations can include brain anomalies, heart defects, and skeletal abnormalities; less common features are hypogonadism in males, hearing impairment, and ophthalmic abnormalities. Most affected individuals have mild nonspecific dysmorphic facial features with or without macrocephaly.
Supranuclear palsy, progressive, 1
MedGen UID:
1640811
Concept ID:
C4551863
Disease or Syndrome
The spectrum of clinical manifestations of MAPT-related frontotemporal dementia (MAPT-FTD) has expanded from its original description of frontotemporal dementia and parkinsonian manifestations to include changes in behavior, motor function, memory, and/or language. A recent retrospective study suggested that the majority of affected individuals have either behavioral changes consistent with a diagnosis of behavioral variant FTD (bvFTD) or, less commonly, a parkinsonian syndrome (i.e., progressive supranuclear palsy, corticobasal syndrome, or Parkinson disease). Fewer than 5% of people with MAPT-FTD have primary progressive aphasia or Alzheimer disease. Clinical presentation may differ between and within families with the same MAPT variant. MAPT-FTD is a progressive disorder that commonly ends with a relatively global dementia in which some affected individuals become mute. Progression of motor impairment in affected individuals results in some becoming chairbound and others bedbound. Mean disease duration is 9.3 (SD: 6.4) years but is individually variable and can be more than 30 years in some instances.
Mitochondrial complex 1 deficiency, nuclear type 12
MedGen UID:
1648278
Concept ID:
C4746984
Disease or Syndrome
Mitochondrial complex 5 (ATP synthase) deficiency nuclear type 5
MedGen UID:
1648429
Concept ID:
C4748269
Disease or Syndrome
Spinocerebellar ataxia, autosomal recessive 27
MedGen UID:
1672866
Concept ID:
C5193058
Disease or Syndrome
Autosomal recessive spinocerebellar ataxia-27 (SCAR27) is an adult-onset neurologic disorder characterized by gait difficulties and other cerebellar signs, such as eye movement abnormalities, dysarthria, and difficulty writing. The disorder is progressive, and some patients may lose independent ambulation. Additional features include spasticity of the lower limbs and cognitive impairment. Brain imaging shows cerebellar atrophy (summary by Eidhof et al., 2018).
Radio-Tartaglia syndrome
MedGen UID:
1778557
Concept ID:
C5543339
Disease or Syndrome
Radio-Tartaglia syndrome (RATARS) is a neurodevelopmental disorder characterized by global developmental delay with impaired intellectual development, speech delay, and variable behavioral abnormalities. Affected individuals show hypotonia, mild motor difficulties, and craniofacial dysmorphism. Brain imaging may show nonspecific defects; rare patients have seizures or pyramidal signs. A subset of individuals may have congenital heart defects, precocious puberty, and obesity in females. Some of the features are similar to those observed in patients with chromosome 1p36 deletion syndrome (607872) (summary by Radio et al., 2021).
Hengel-Maroofian-Schols syndrome
MedGen UID:
1794242
Concept ID:
C5562032
Disease or Syndrome
Hengel-Maroofian-Schols syndrome (HEMARS) is an autosomal recessive neurodevelopmental disorder characterized by severe global developmental delay apparent from infancy or early childhood. Affected individuals have delayed walking or inability to walk, impaired intellectual development with poor or absent speech, pyramidal signs manifest as lower limb spasticity, poor overall growth often with short stature and microcephaly, and dysmorphic facial features. Some patients develop seizures. Brain imaging shows thinning of the posterior part of the corpus callosum, delayed myelination, and cerebral and cerebellar atrophy (Hengel et al., 2021).

Professional guidelines

PubMed

Costales M, Casanueva R, Suárez V, Asensi JM, Cifuentes GA, Diñeiro M, Cadiñanos J, López F, Álvarez-Marcos C, Otero A, Gómez J, Llorente JL, Cabanillas R
Otolaryngol Head Neck Surg 2022 Jan;166(1):74-79. Epub 2021 May 4 doi: 10.1177/01945998211008398. PMID: 33940977
Carender WJ, Grzesiak M, Telian SA
Otolaryngol Clin North Am 2021 Oct;54(5):1015-1036. Epub 2021 Jul 23 doi: 10.1016/j.otc.2021.05.018. PMID: 34304897
Tolosa E, Valldeoriola F, Marti MJ
J Neural Transm Suppl 1994;42:15-31. doi: 10.1007/978-3-7091-6641-3_2. PMID: 7964684

Recent clinical studies

Etiology

Chua MMJ, Blitz SE, Ng PR, Segar DJ, McDannold NJ, White PJ, Christie S, Hayes MT, Rolston JD, Cosgrove GR
Mov Disord 2023 Oct;38(10):1962-1967. Epub 2023 Aug 4 doi: 10.1002/mds.29569. PMID: 37539721
Ahluwalia R, Maffulli N, Lázaro-Martínez JL, Kirketerp-Møller K, Reichert I
Surgeon 2021 Dec;19(6):e526-e535. Epub 2021 Feb 26 doi: 10.1016/j.surge.2021.01.005. PMID: 33642205
Haddas R, Ju KL, Boah A, Kosztowski T, Derman PB
Clin Spine Surg 2019 Nov;32(9):369-376. doi: 10.1097/BSD.0000000000000889. PMID: 31498275
Horowitz JA, Puvanesarajah V, Jain A, Raad M, Gjolaj JP, Shen FH, Hassanzadeh H
Spine (Phila Pa 1976) 2019 Jan 15;44(2):96-102. doi: 10.1097/BRS.0000000000002762. PMID: 29939973
Mustapa A, Justine M, Mohd Mustafah N, Jamil N, Manaf H
Biomed Res Int 2016;2016:9305025. Epub 2016 Jul 20 doi: 10.1155/2016/9305025. PMID: 27525281Free PMC Article

Diagnosis

Rajan PV, Pelle DW, Savage JW
Clin Spine Surg 2022 Dec 1;35(10):422-430. Epub 2022 Nov 1 doi: 10.1097/BSD.0000000000001408. PMID: 36447347
Ageely GA, Alsulami SS, Alkenani AA, Albeshri EE
Saudi Med J 2022 Sep;43(9):1057-1061. doi: 10.15537/smj.2022.43.9.20220346. PMID: 36104063Free PMC Article
Cohen DA, Bhatti MT, Chen JJ, Mauermann ML, Gold DR
Surv Ophthalmol 2020 Jul-Aug;65(4):487-493. Epub 2019 Apr 19 doi: 10.1016/j.survophthal.2019.04.004. PMID: 31009615
Smouha E
NeuroRehabilitation 2013;32(3):455-62. doi: 10.3233/NRE-130868. PMID: 23648600
Mpairamidis E, Alexiou GA, Stefanaki K, Sfakianos G, Prodromou N
J Child Neurol 2008 Dec;23(12):1481-3. doi: 10.1177/0883073808319316. PMID: 19073857

Therapy

Ghorbanpour S, Rahimibarghani S, Rohani S, Rastkar M, Ghajarzadeh M
Neurol Sci 2023 Sep;44(9):3059-3069. Epub 2023 Apr 14 doi: 10.1007/s10072-023-06795-9. PMID: 37055710
Sugiyama A, Nishigori C, Tsujimoto M, Togawa Y, Kuwabara S
Neurology 2022 Oct 4;99(14):618-624. Epub 2022 Aug 2 doi: 10.1212/WNL.0000000000201065. PMID: 35918170
Grajny K, Durphy J, Adam O, Azher S, Gupta M, Molho E
Tremor Other Hyperkinet Mov (N Y) 2020 Oct 6;10:37. doi: 10.5334/tohm.431. PMID: 33101763Free PMC Article
Srinivasan SR, Shakkottai VG
Neurotherapeutics 2019 Oct;16(4):999-1008. doi: 10.1007/s13311-019-00763-y. PMID: 31338702Free PMC Article
Korkmaz OT, Tunçel N
Curr Pharm Des 2018;24(39):4693-4701. doi: 10.2174/1381612825666190111150953. PMID: 30636594

Prognosis

Zeneli A, Montalti S, Masciangelo I, Manieri G, Golinucci M, Nanni O, Montella MT, Martinelli G, Petracci E
Support Care Cancer 2022 Oct;30(10):7835-7843. Epub 2022 Jun 16 doi: 10.1007/s00520-022-07208-x. PMID: 35705752
Pineda-Pardo JA, Urso D, Martínez-Fernández R, Rodríguez-Rojas R, Del-Alamo M, Millar Vernetti P, Máñez-Miró JU, Hernández-Fernández F, de Luis-Pastor E, Vela-Desojo L, Obeso JA
Neurosurgery 2020 Aug 1;87(2):256-265. doi: 10.1093/neuros/nyz395. PMID: 31574145
Horowitz JA, Puvanesarajah V, Jain A, Raad M, Gjolaj JP, Shen FH, Hassanzadeh H
Spine (Phila Pa 1976) 2019 Jan 15;44(2):96-102. doi: 10.1097/BRS.0000000000002762. PMID: 29939973
Faryniuk JH, Zeigelboim BS, Teive HAG, Fo VR, Liberalesso PBN, Marques JM
Int Tinnitus J 2017 Apr 19;20(2):93-101. doi: 10.5935/0946-5448.20160018. PMID: 28422031
El Ters M, Patel SM, Norby SM
Endocr Pract 2014 May;20(5):490-9. doi: 10.4158/EP12084.RA. PMID: 24325990

Clinical prediction guides

Ghorbanpour S, Rahimibarghani S, Rohani S, Rastkar M, Ghajarzadeh M
Neurol Sci 2023 Sep;44(9):3059-3069. Epub 2023 Apr 14 doi: 10.1007/s10072-023-06795-9. PMID: 37055710
Sugiyama A, Nishigori C, Tsujimoto M, Togawa Y, Kuwabara S
Neurology 2022 Oct 4;99(14):618-624. Epub 2022 Aug 2 doi: 10.1212/WNL.0000000000201065. PMID: 35918170
Sarter M, Avila C, Kucinski A, Donovan E
Mov Disord 2021 Mar;36(3):535-546. Epub 2021 Feb 22 doi: 10.1002/mds.28532. PMID: 33615556Free PMC Article
Pineda-Pardo JA, Urso D, Martínez-Fernández R, Rodríguez-Rojas R, Del-Alamo M, Millar Vernetti P, Máñez-Miró JU, Hernández-Fernández F, de Luis-Pastor E, Vela-Desojo L, Obeso JA
Neurosurgery 2020 Aug 1;87(2):256-265. doi: 10.1093/neuros/nyz395. PMID: 31574145
Boolani A, Martin R, Goodwin A, Avolio A, Sur S, Lee Smith M, Fulk G
Int J Rehabil Res 2019 Jun;42(2):160-167. doi: 10.1097/MRR.0000000000000347. PMID: 30882529

Recent systematic reviews

Ghorbanpour S, Rahimibarghani S, Rohani S, Rastkar M, Ghajarzadeh M
Neurol Sci 2023 Sep;44(9):3059-3069. Epub 2023 Apr 14 doi: 10.1007/s10072-023-06795-9. PMID: 37055710
Mustapa A, Justine M, Mohd Mustafah N, Jamil N, Manaf H
Biomed Res Int 2016;2016:9305025. Epub 2016 Jul 20 doi: 10.1155/2016/9305025. PMID: 27525281Free PMC Article

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