Understanding Gait Apraxia: Causes, Symptoms, and Treatment

Gait apraxia is a neurological condition that affects walking. Patients often feel like they forget how to walk, even though their legs and muscles are physically fine. This blog explains its symptoms, underlying causes, and possible treatments.

What is Gait Apraxia?

Gait apraxia occurs when a person struggles to start walking or takes a few steps awkwardly. Though the muscles are strong, the brain fails to coordinate movement efficiently.
Key characteristics:

• Difficulty initiating walking
• Short, shuffling steps
• Slight imbalance or unsteady movement

People with gait apraxia may appear slightly uncoordinated, even though their leg strength is normal.

Common Symptoms

Gait apraxia often comes with additional symptoms:

1. Trouble walking – difficulty starting, shuffling steps, or unusual patterns.
2. Loss of bladder control – reduced control while walking.
3. Mild forgetfulness – short-term memory or concentration issues.

These symptoms may indicate a neurological disorder such as normal pressure hydrocephalus (NPH) or brain cell degeneration.

Causes of Gait Apraxia

Gait apraxia is often linked to:

• Normal Pressure Hydrocephalus (NPH): A condition where cerebrospinal fluid builds up in the brain, increasing pressure and causing walking difficulty.
• Brain cell degeneration: Brain tissue shrinks, creating extra fluid pressure and disrupting motor signals.
  Correct diagnosis is crucial for effective management.

Diagnosis: The Role of Lumbar Puncture

A lumbar puncture (spinal tap) can help determine whether excess fluid is causing gait apraxia:

• Fluid is removed from the lower spine over 5 consecutive days (30–50 ml each day).
• Symptoms are monitored before and after fluid removal.
• Positive response: If walking improves, fluid buildup is likely the cause.
• No response: If no improvement, cell degeneration may be the cause.

This simple procedure helps guide further treatment decisions.

Treatment Options

Treatment depends on the underlying cause:
1. If fluid buildup is the cause:

• A minor surgical procedure may help divert cerebrospinal fluid and relieve pressure.
• This can significantly improve walking and bladder control.

2. If brain cells have degenerated:

• Surgery may not be effective.
• Management focuses on physical therapy, lifestyle adjustments, and supportive care.

Recovery and Follow-Up

• After fluid removal or surgery, patients are usually monitored for 15–30 minutes before discharge.
• Physical therapy and regular follow-up are recommended to track progress.
• Early detection and intervention can improve outcomes and quality of life.