Stamping Gait : Causes, Symptoms, Diagnosis & Treatment

Last Updated: 30/09/2022

Stamping gait is observed when deep sensitivity is disturbed against the background of lesions of the central and peripheral nervous system: injuries, tumors, hemorrhages in the brain and spinal cord, inflammatory and non-inflammatory lesions of the spinal cord, polyneuropathies of various etiologies, multiple sclerosis, Friedreich's ataxia, Guillain-Barré syndrome. The etiology of the disorder is established on the basis of an anamnesis, data from a general and neurological examination, imaging and laboratory techniques. Vitamins, nootropics, cholinesterase agents, exercise therapy, physiotherapy, and surgical methods are used in the treatment.

Features of stamping gait

A change in gait develops as a result of damage to any part of the proprioceptive system responsible for deep sensitivity: receptors in muscles, tendons and skin, peripheral nerves, posterior columns of the spinal cord and brain, ventrolateral thalamic nucleus, parietal lobe, precentral gyrus. Due to the inability to feel his own body, the patient makes exaggerated, too strong movements under careful visual control.

The patient excessively flexes and unbends the legs in the joints, spreads them widely at each step, with force lowers the limb to the floor, hitting the heels on the surface. Due to the inability to feel contact with the floor, it seems to a person that he “falls through”, walks “as if on cotton wool”. When moving, the patient constantly looks at his feet. In the absence of visual control, gait disturbances increase so much that walking becomes impossible.

Why there is a stamping gait

Cerebral tumors

A stamping gait is formed with lesions of the corresponding areas of the cortex, thalamus, medulla oblongata:

  • Tumors of the cerebral hemispheres. There are dull diffuse headaches with vomiting at the peak of cephalalgia, paroxysmal systemic dizziness, congestive optic discs, and mental disorders.
  • Neoplasia of the brain stem. Strabismus, nystagmus, hearing loss, paresis of the facial nerve, hearing loss, hand tremors are possible. Cerebral symptoms often join in the later stages of the disease.
  • Neoplasms of the thalamus. Disorders of skin sensitivity, burning pains in one or both halves of the body, hyperkinesis, hyperpathia are revealed.

Symptoms gradually increase, the list of manifestations expands. The rate of progression depends on the rate of tumor growth, and is higher in malignant neoplasia.

brain strokes

The clinical picture of ischemic or hemorrhagic stroke is formed suddenly. Cerebral and focal symptoms are revealed. Headache, vomiting are combined with disorders of consciousness. Hemiparesis is often observed, manifested by a distortion of the face, muscle weakness, impaired sensitivity of half of the body. Aphasia, dysphagia, hearing disorders, reduced criticism are possible. The severity of stamping gait, other residual effects in the long term varies.

Injuries and operations

Stamping gait is the result of severe head injury with fractures of the bones of the vault and base of the skull, crush injuries, brain contusions, intracerebral, epidural, subdural hematomas. Sometimes it is formed after surgical interventions on the corresponding structures with tumors, abscesses, vascular lesions, and other pathologies.

stamping gait


Tumors of the spinal cord

Symptoms depend on the location of the tumor. With extramedullary neoplasia, radicular symptoms initially predominate, which may resemble manifestations of sciatica in patients with degenerative lesions of the spinal column. With an intramedullary location, a spinal cord neoplasm manifests as dissociated sensory disorders. In the future, there is an increase in motor and sensory disorders.

Stamping gait is a possible, but not obligatory symptom; it is found when the hind horns are affected against the background of the relative safety of other structures. With further spread of neoplasia, it is supplemented by paresis, paralysis.

spinal strokes

In the acute period of hemorrhagic or ischemic spinal stroke, depending on the location of the pathological focus, tetra- or paraplegia develops, violations of all types of sensitivity. Subsequently, residual effects of varying severity are observed, one of the variants of which is a stamping gait.

Spinal cord injury

Neurological disorders can occur at the time of injury (with spinal cord contusion, compression or damage to spinal structures by displaced vertebrae, vertebral fragments) or appear after a while (during the formation of a hematoma, secondary displacement of bone and cartilage structures). The clinical picture is variable, determined by the localization, prevalence of the lesion.

Other diseases of the spinal cord

Stamping gait can be a sign of the following diseases:

  • funicular myelosis. Neurological symptoms develop against the background of vitamin B12 deficiency. Violations of deep sensitivity precede the onset of lower paraparesis. Mental disorders of a neurotic level are possible, psychoses are less often observed.
  • Myelitis. It is observed in infections, traumatic injuries, acute and chronic intoxications. Pathology manifests itself as back pain. Subsequently, neurological disorders join, the nature and severity of which depend on the volume and level of the lesion.
  • Dorsal dryness. It is a clinical variant of neurosyphilis. Disorders of deep sensitivity are noted already at the onset of the disease, are progressive in nature, lead to the development of sensitive ataxia, stamping gait.

Peripheral nerve damage

Stamping gait accompanies various types of polyneuropathy. Symmetric sensory disturbances are typical, gradually spreading from the distal to the proximal. Initially, positive sensory disorders predominate: paresthesia, hyperesthesia. Then hypesthesia develops, with the defeat of thick myelinated fibers, changes in gait are formed. The symptom is detected in alcoholic, metabolic, infectious-toxic, autoimmune polyneuropathies, including Guillain-Barré syndrome.

Common lesions of the nervous system

There are a number of diseases with sensitive ataxia due to the simultaneous involvement of the peripheral and central nervous system. An example of such a pathology is multiple sclerosis, in which the gait is both shaky and stamping. Pathology is characterized by a polymorphic clinical picture with pyramidal, cerebellar symptoms, and movement disorders. In most cases, a relapsing course is observed.

With Friedreich's ataxia, as in the previous case, the gait has a shaky or stamping character. Changes in the walking pattern are detected in the early stages, then neurological symptoms progress, paresis, atrophy of the lower extremities are detected. In the future, the upper limbs are involved in the process. Bone deformities are formed. Possible cardiomyopathy, atrophy of the optic nerves, dementia.


Diagnostic measures are carried out by a neurologist. The specialist finds out when the stamping gait appeared, what symptoms it was accompanied by, what injuries or diseases preceded the development of this disorder. During the examination, a characteristic pattern of walking is revealed, instability in the Romberg position, which increases when the eyes are closed. In a position with arms extended forward, pseudoathetosis is possible.

The results of coordinating tests are unsatisfactory. The tone of the muscles of the lower extremities is reduced. Other focal and cerebral symptoms may be present. The additional examination plan includes the following procedures:

  • Electroencephalography. It is used to detect volumetric formations of the brain, allows you to assess the severity of brain function disorders in neurological diseases, after hemorrhages, traumatic injuries.
  • Magnetic resonance imaging. To clarify the nature and localization of pathological processes in the brain stem, thalamus, and cortex, an MRI of the brain is performed. In case of injuries, tumors, myelitis, myelosis, an MRI of the spine is performed.
  • CT scan. Informative for strokes, tumors, traumatic injuries. It makes it possible to assess the severity of damage to the skull and spine, confirm the presence of edema, hematomas, hemorrhages, displacement of brain structures, and conduct differential diagnosis of neoplasms.
  • Electrophysiological Methods . Electroneurography, electromyography, the study of evoked potentials are carried out to determine the degree and level of nerve damage, the study of neuromuscular transmission, the state of the pathways.
  • Laboratory tests . Recommended for establishing the causes and differential diagnosis of neuropathies. Indicated for suspected neurosyphilis, genetic diseases. The material used is cerebrospinal fluid, blood, urine.

Neurological rehabilitation



Conservative therapy

In the treatment of diseases accompanied by a stamped gait, medicines of the following groups are used:

  • B group vitamins . Contribute to the improvement of the condition of the nervous and muscle tissue. More often administered intramuscularly.
  • Vascular drugs . Required for patients with circulatory disorders.
  • Anticholinesterase agents . Recommended for neuropathies, severe muscle atrophy.
  • Nootropics . Used to normalize brain activity, improve nerve transmission.

For tumors, chemotherapy and radiation therapy may be indicated. Drug treatment is supplemented with physiotherapy, massage, acupuncture. Patients are trained in physiotherapy exercises aimed at improving coordination of movements.


Patients with stamping gait undergo the following surgical interventions:

  • Tumors : removal of intracerebral neoplasms, neoplasia of the trunk and thalamus, intramedullary and extramedullary volumetric formations.
  • Circulatory disorders : removal, embolization and occlusion of aneurysms, thrombolysis, formation of vascular anastomoses.
  • Traumatic injuries : removal of depressed skull fractures, decompressive craniotomy, open or endoscopic removal of hematomas.

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