Astasis

Definition

Definition of Astasis
Astasis is a lack of motor coordination marked by an inability to stand, walk or even sit without assistance due to disruption of muscle coordination.

The term "astasia" is interchangeable with "astasis" and is most commonly referred to as astasia in the literature describing it. Astasis is the inability to stand or sit up without assistance in the absence of motor weakness or sensory loss (although the inclusion of 'the lack of motor weakness' has been debated by some physicians). It is categorized more as a symptom than an actual disease, as it describes a disruption of muscle coordination resulting in this deficit. The disturbance differs from cerebellar ataxia in the fact that with astasis the gait can be relatively normal, with balance significantly impaired during transition from a seated to standing position. This balance impairment is similar to patients with vestibulocerebellar syndrome, which is a progressive neurological disease with many symptoms and effects.

Symptoms

Symptoms of Astasis
Since astasis itself is more a symptom than a disease, it is more often seen associated with other signs and symptoms. People who have astasis often experience:

1. Odd gyrations
2. Tightrope balancing deficits (in which a person attempts to balance on a tightrope in order to test balance and motor coordination)
3. Near falling deficits (which is a test in which the patient is slightly pushed in order to check their ability to regain posture)
4. Exaggerated effort deficits (which is an overcompensation test used to determine motor coordination ability)
5. Atypical postures and weakness
6. Paralysis
7. Jumping fits (in which motor control is partially or totally lost)
8. Tremors

Causes

Causes of Astasis
There are many speculations as to what is the main cause of astasis. A combination of weakness of the triceps surae muscle, peripheral neuropathy, and irregular postural movements are the leading theories thus far. Diabetes, spinal root or spinal cord lesions, and traumas or injuries to the motor cortex of the brain can also cause similar symptoms that are seen in patients with astasis. However, none of these have been proven definite. Many scientists also believe that this is a conversion disorder, in which patients exhibit symptoms without any neurological cause.

1. Peripheral Neuropathy: Damage to the peripheral nerves coming from the legs to the somatosensory area is the leading candidate for the cause of astasis. These damaged nerves prevent feedback for stabilization of posture for patients with astasis. This causes a disturbance in postural movements, such as a swaying around the legs and hip joints. This swaying may be seen only when a patient in standing still, and may disappear before walking, indicating that these patients exhibit astasia without abasia. This impairment of sensation is not always required for the sensation to develop. However, impairment often worsens astasia.
2. Diabetes: Many patients who suffer from diabetes can have damage to a single nerve or groups of nerves in the body. Some patients experience damage to the nerves coming from the somatosensory area controlling postural stability, which can cause symptoms similar to those seen in patients with astasia. These patients exhibit trouble standing and hip swaying. This damage can be caused by a wide array of things, such as high blood glucose levels, or decreased blood flow to the brain.
3. Spinal Cord/Root Lesions: Lesions in the spinal cord or the spinal root can cause damage to a nerve or nerve root. Depending on where the abnormality is in a patient they can experience a wide range of symptoms, including those that are found in patients with astasis. It has been seen that patients with spinal atrophy who have astasia without abasia have neither sensory disturbances of the lower limbs or weakness in the hip extensor flexor muscles. This helps to indicate that one of the main causes of astasia without abasia is weakness in the triceps surae muscle.

Diagnosis

Diagnosis of Astasis
Consult with your doctor.

Treatment

Treatment of Astasis
The most effective treatment of astasia seems to be a removal of stress inducing stimuli and allowing the patient to rest and regain strength. Despite the lack of a direct prescribable cure for the effect of astasia on the motor system of the legs, in almost all documented cases physical rehabilitation and relief from mental stressors have led to a full recovery. Although astasia is not expressly associated with any neurological disorders, there is a strong correlation between general mental hysteria and the symptoms of astasia. Therefore, isolation of the patient from the situation causing them hysteria is the most efficient way to rid them of disabling motor symptoms. Another method for treatment that patients who experience astasia is to have therapy for the triceps surae muscle. This therapy can help strengthen these muscles to help maintain an upright posture. It has also been suggested that ankle-foot orthoses be prescribed for these patients. This would help patients with astasia maintain balance by preventing ankle dorsiflexion.

Currently, physical therapy and rehabilitation are widely accepted as the best treatments for the symptoms of astasia. There is, however, evidence to suggest that regulation of a patient's social situation and behavioral influences can influence the effectiveness of rehabilitation. A 1975 study shows that when a patient is given direct encouragement and social distractions their physical recovery proceeds much faster than when only basic instructions are provided to them.

Prognosis

Prognosis of Astasis
Consult with your doctor.

Prevention

Prevention of Astasis
Consult with your doctor.