It is the gait of patients who have lost sensory and proprioceptive sensation in the lower extremities. In the
golden days of syphilis, this used to be pathognomonic of tabes dorsalis, but now it is mostly due to
neuropathy of large afferent fibers. Patients with sensory ataxia are unaware of their limbs’ position in
space; hence, they walk by taking steps that are higher than necessary, while at the same time carefully
monitoring the ground. Although their gait is as wide as that of cerebellar ataxia, only patients with sensory
ataxia typically slap the foot onto the ground (to increase peripheral input). And although their stance is
as wide based as that of cerebellar ataxia, only sensory ataxia patients have positive a Romberg’s sign
(swaying and falling after loss of compensatory visual input). This is also why they have difficulty walking at
night.
golden days of syphilis, this used to be pathognomonic of tabes dorsalis, but now it is mostly due to
neuropathy of large afferent fibers. Patients with sensory ataxia are unaware of their limbs’ position in
space; hence, they walk by taking steps that are higher than necessary, while at the same time carefully
monitoring the ground. Although their gait is as wide as that of cerebellar ataxia, only patients with sensory
ataxia typically slap the foot onto the ground (to increase peripheral input). And although their stance is
as wide based as that of cerebellar ataxia, only sensory ataxia patients have positive a Romberg’s sign
(swaying and falling after loss of compensatory visual input). This is also why they have difficulty walking at
night.