Neurological disorders of gait, balance and posture: A sign-based approach

Jorik Nonnekes, Rianne J.M. Goselink, Evzen Růzicka, Alfonso Fasano, John G. Nutt, Bastiaan R. Bloem

Research output: Contribution to journalReview articlepeer-review

79 Scopus citations


Neurological disorders of gait, balance and posture are both debilitating and common. Adequate recognition of these so-called disorders of axial mobility is important as they can offer useful clues to the underlying pathology in patients with an uncertain clinical diagnosis, such as those early in the course of neurological disorders. Medical teaching programmes typically take classic clinical presentations as the starting point and present students with a representative constellation of features that jointly characterize a particular axial motor syndrome. However, patients rarely present in this way to a physician in clinical practice. Particularly in the early stages of a disease, patients might display just one (or at best only a few) abnormal signs of gait, balance or posture. Importantly, these individual signs are never pathognomonic for any specific disorder but rather come with an associated differential diagnosis. In this Perspective, we offer a new diagnostic approach in which the presenting signs are taken as the starting point for a focused differential diagnosis and a tailored search into the underlying neurological syndrome.

Original languageEnglish (US)
Pages (from-to)183-189
Number of pages7
JournalNature Reviews Neurology
Issue number3
StatePublished - Mar 1 2018

ASJC Scopus subject areas

  • Clinical Neurology
  • Cellular and Molecular Neuroscience


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