Abasia: types and characteristics of this incapacity

There are different disorders or injuries that can prevent or hinder a person's ability to walk.

One of which we can find is the abasia. Next we will discover what characteristics this pathology has, how it can originate and what are the possible treatments that can be applied to achieve improvement.

• Related article: "Apraxia: causes, symptoms and treatment"

What is the abbasia?

Abasia is a medical disorder that refers to a lack of ability in the subject who suffers from it to coordinate the movements necessary to be able to walk, which would be a form of ataxia. As a result, the action of standing or taking steps becomes difficult or impossible, depending on the severity of the abasia in the subject.

Those who can walk do so in an erratic and clumsy way, falling to the ground being very likely, since the Impossibility of coordination makes the person need a titanic effort to link several steps in a row, if they manage to do so. get.

One of the problems that makes this pathology prevent the patient from walking is that the steps that are managed to take do not keep a general trend in terms of distance, so sometimes shorter and sometimes longer steps are taken, randomly, preventing regular progress, which makes you lose balance frequently.

Abasia can sometimes be accompanied by another movement deficit known as astasia., and that implies a lack of ability in the subject to remain vertical, that is, standing, without external help (someone to hold him or some element to lean on).

organic causes

Abasia arises from damage to certain brain regions, and can have a diverse origin. It can be caused, for example, by a stroke, that is, a cerebrovascular accident, which would leave a part of the brain involved in the movements necessary to walk without oxygen.

It can also be caused by a condition known as hydrocephalus., which alters the pressure levels of the brain due to an excess of cerebrospinal fluid surrounding this organ, and therefore it can also damage part of its tissues, generating different pathologies depending on the area affected. One of them would be the abbasia.

Another of the diseases that could end up leading to difficulty in coordinating the steps would be Parkinson's, one of the best-known neurological pathologies. When suffering a progressive degeneration of the neuronal tissue, there may come a time when critical points in the brain that allow us to walk are damaged, beginning to suffer, from that moment, of abasia.

There are lesser-known diseases, such as Guillain Barre syndrome, which are also sometimes responsible for triggering the disorder in question. In this case we would be talking about an autoimmune disease, which little by little causes the paralysis of the extremities, making it increasingly difficult for the person to walk, apart from many other symptoms such as loss of sensitivity.

However, in the case of Guillain-Barré syndrome, the patient's ability to recover is very good. In general, up to 90% of those affected by this disorder usually improve and recover almost completely approximately twelve months after the onset of symptoms.

Another reason that can generate an abasia would be any damage that affects the cerebellum, and more specifically in the part of the vermis, a tissue that joins both the two hemispheres of the cerebellum itself, and that is involved in the conscious proprioceptive processes of the individual.

• You may be interested in: "Cerebral Palsy: Types, Causes, Symptoms, and Treatment"

phobias

We have made a tour of a multitude of organic diseases and injuries that could generate, among many other symptoms, an abasia. However, these are not the only ways in which a person can have serious problems standing and walking.

And it is that we must not lose sight of the psychological part of the subject and how powerful some irrational fears can be, such as phobias. In this sense, There are several types of phobias that would directly or directly affect the person's ability to move using their feet.

Basophobia

One of them would be basophobia or basiphobia, a phobia consisting of a terrible fear of tripping and falling while we are walking, which blocks the subject in such a way that it can force him to remain sitting or lying down all the time so as not to see fulfilled that fear that frightens you, which would be another way of abbasia

It occurs especially in older people, who have already begun to suffer a degenerative process and do not feel safe to walk, because they fear the consequences of a possible fall, which could cause significant injuries such as a broken hip or other bones.

It is also possible to have acquired this phobia from an actual fall, which has so collapsed the ability to processing of the subject that his brain has established not walking as a method to avoid suffering similar damage. This is a very common origin in various types of phobias (having suffered real damage and therefore avoiding the behavior that led to that first incident at all costs, so that nothing is ever experienced again So).

stasiphobia

Another fear very similar to the previous one would be stasiphobia, that instead of walking, refers to the very fact of standing, so it would also be limiting the other behavior, since, as is logical, you cannot walk if you are not standing.

In addition to stasiphobia, other terms can also be found to refer to this same phobia that is causing abasia through psychological factors. Some of them would be Ambulophobia, Stasiphobia or Stasophobia.

Stasobasophobia

In addition, stasiphobia can occur together with basophobia, in what is known by the term clinical diagnosis of stasobasophobia, a type of multiple phobia in which both behaviors.

On the one hand, the person would be unable to stand up, due to the terror that the idea implies. But also, he would not be able to consider walking, since that action, by itself, also causes fear in the person, which therefore is incapacitated for any task that involves moving with her legs.

Guys

Within the abasias that have an organic base behind, there is a wide typology according to the implications of this restriction of leg movement. We are going to know the different types that we can find.

1. atactic abbasia

On the one hand we would find the atactic abasia, that in which the subject experiences a lack of certainty when moving.

2. abbasia choreica

Choreic abasia, on the other hand, would be triggered by chorea (involuntary movements) that would affect the person's lower extremities.

3. paralytic abbasia

We would also find the paralytic type abasia, caused by the patient's inability to move the muscles of the legs and therefore suffer from an impossibility to walk.

• You may be interested in: "Medullary syndromes: types, causes and symptoms"

4. spastic abasia

This type of abasia, the spastic, would be taking place when a dysfunction of the organism causes the muscles of the legs (at least those, since they are the ones that concern us) to remain contracted all the time, thus hindering their voluntary movement.

5. spasmodic abbasia

Spasmodic abasia is similar to the previous type, but in this case muscles do not have to be constantly tense, but the person would suffer from involuntary spasms that randomly contract and relax them.

6. tremulous abbasia

In the case of the tremulous abasia, all the muscles involved in the movements required to take steps would suffer from constant tremors, which would make it difficult for the individual to walk. This modality is also known as trembling abasia.

7. abasia with astasia

We have already anticipated that the abasia can only appear as difficulty moving the legs to walk, but it can also lead to coupled with astasia, with which the individual would not even have the ability to get up and stay on his feet, or he would do so but with a lot of difficulty.

This type of abasia is also called Blocq's disease., known by this name for having been a disorder described for the first time by the French physician Paul Blocq, at the end of the 19th century.

In this case, we would be talking about a type of ataxia in which the automatic ability we have to carry out the movements involved in walking would be lost, but the curious thing is that when lying down, he could move his legs and his different muscle groups without problem.

In this case, the origin of the pathology would be in the substantia nigra of the basal ganglia, as we had already anticipated in the list of possible causes for some types of abasia.

Bibliographic references:

• Munford, P.R., Paz, G. (1978). Differential attention in the treatment of astasia-abasia. Journal of Behavior Therapy and Experimental Psychiatry. Elsevier.
• Okun, M.S., Koehler, P.J. (2007). Paul Blocq and (psychogenic) astasia abasia. Official journal of the Movement Disorder.
• Sinel, M., Eisenberg, M.S. (1990). Two unusual gait disturbances: astasia abasia and camptocormia. Archives of physical medicine and rehabilitation.
• Stickler, G.B., Cheung-Patton, A. (1989). Astasia-Abasia: A Conversion Reaction Prognosis. Clinical pediatrics.