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muscles and prevents the patient from climbing. This inability to climb is also seen in those exhibit- Buy Trileptal Online ing the waddling gait. 6. The tottering gait. — Seen in those who have taken large doses of bromides for long periods ; also in hydrocephalus, in Korsakoff's disease (psychosis polyneuritica) and in idiopathic muscular atrophy. Fig. 3. — Pelmatogram of a male, showing fiat foot. 7. The shuffling gait is Cost Of Trileptal the gait Purchase Trileptal Online seen in normal old age or senility and is associated with slowly pro- gressive loss of strength and mentality. It is also seen in Trileptal 135 Mg general paresis and is the usual gait of the longterm prison inmate. The patient gives the im- pression of being too lazy to lift his feet and instead pushes them along with his legs. 8. The "Charlie Chaplin" gait Trileptal 150 Mg has been errone- ously described as an ataxic gait. It is rather a combination of the "funny part" of several gaits in which the waddling, shuffling, tottering paretic gaits predominate and to which some elements of the spasticparetic, as well as the ataxic gaits, have been added. The inspiration must have come originally to the celebrated movie star from some waddling cripple whom he proceeded to imitate and later bur- lesqued. B. The moderate or flaccid paretic gait. — In this form of the paretic gait there is commonlv a Tegretol Vs Trileptal paresis of a certain group of muscles, usually the extensors of the foot or the peronei, causing toe drop and apparent lengthening of the afifected ex- tremity. It Trileptal Cost corresponds to the wrist drop of the upper extremity. To compensate for the lengthen- 496 LUTTINGER: LOCOMOTION AS AN AW IN DIAGNOSIS. [New York EDiCAL Journal. ing of the limb, overflexion^at the hip or knee, or at both joints, takes place. The limb is flaccid or flabby. The foot is lifted high up with each step in order to raise it clear ofif the ground and avoid trip- Trileptal Generic Name ping. As the foot is brought down, heel first, Trileptal Tablets this gait may sometimes be confused with tabes and is therefore sometimes referred to as the pseudotab- etic gait. It is, however, easily differentiated from the true tabetic gait by its characteristic high action or high stepping quality which made Charcot com- pare it to the gait of a horse and call it : 1. The steppage gait, mostly seen in the chronic intoxications producing neuritis. It resembles the gait of a man w-alking through thick grass or brush- Trileptal 60 Mg wood and stepping over constantly recurring but nonexistent obstacles. The typical steppage gait is seen in arsenical neuritis with ankle drop, also in alcoholic neuritis, polyneuritis potatorum (ataxia of drunkards) and in lead neuritis (lead palsy, Trileptal Acne plumbism, Trileptal Coupon saturnism), in Trileptal 450 Mg which first the peroneal muscles are affected, later the extensor communis digitorum and finally the extensor proprius hallucis. Phosphorus, copper and grain (ergotism) poisoning may give rise to a neuritis in the lower extremities and produce the characteristic steppage gait. Tuberculosis, malaria, diabetes, and diphtheria (motor form) may sometimes produce this gait. It may Cheap Trileptal also develop as a sequel of sunstroke (ther- mic fever, insolation) and in fact following any disease which will cause peripheral neuritis of the anterior tibial nerve. 2. The prancing gait is an exaggeration of the preceding gait. It is seen in epidemic anterior poliomyelitis (infantile paralysis) when the disease Buy Cheap Trileptal aft'ects the anterior horn cells of the Order Trileptal lumbar cord, causing atrophy of the extensor muscles of the foot, resulting in foot drop. It is also seen in acute ascending paralysis (Landry's disease), which is probably a form of poliomyelitis, and in progressive hereditary muscular atrophy of the leg (Charcot- Marie-Tooth type) when the muscles of the leg, not the foot, are primarily affected, i. e., first the peronei become atrophied, later the extensors of the toes and finally the calcaneal muscles. Finally the prancing may be seen Trileptal 150 in connection with certain tumors of the cord, unilateral hip disease, disloca- tion, or injury, Order Trileptal Online and in multiple neuritis and beriberi (epidemic multiple neuritis). C. The spastic or severe Trileptal Vs Tegretol paretic gait. — The spastic gait is due to the hypertonicity of the weak- ened muscles, the resulting stiffness causing a slow-

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