A patient came to OPD with a stamping gait. On examination,when he was asked to close his eyes and walk, he fails to walk. Which of the following tracts is most probably affected?
## **Core Concept**
The question tests knowledge of proprioception and the sensory pathways in the spinal cord. A stamping gait and inability to walk with eyes closed suggest a problem with proprioceptive input, which is essential for coordinated movement and balance.
## **Why the Correct Answer is Right**
The correct answer, **Dorsal Column (Posterior Column)**, is right because this pathway is responsible for transmitting proprioception (position sense), vibration, and fine touch. The dorsal column pathway includes the fasciculus gracilis and fasciculus cuneatus, which carry sensory information from the lower and upper parts of the body, respectively, to the brain. Damage to this pathway results in loss of proprioception, leading to a stamping gait (also known as a sensory ataxic gait) and a positive Romberg sign, where the patient is unable to stand or walk with their eyes closed.
## **Why Each Wrong Option is Incorrect**
- **Option A:** The **Spinothalamic Tract** is involved in transmitting pain and temperature sensation. Damage to this tract would not cause the symptoms described.
- **Option B:** The **Lateral Corticospinal Tract** is primarily involved in motor function, specifically transmitting signals for voluntary movement. Damage here would more likely result in motor weakness or paralysis rather than the sensory ataxia described.
- **Option C:** The **Anterior Corticospinal Tract** also plays a role in motor function. Like the lateral corticospinal tract, damage to this area would likely result in motor deficits rather than the proprioceptive issues described.
## **Clinical Pearl / High-Yield Fact**
A key clinical correlation to remember is the Romberg test, which assesses a patient's proprioception by asking them to stand with feet together and then close their eyes. A positive test, indicated by an inability to maintain balance with eyes closed, suggests a problem with proprioception, often due to dorsal column disease.
## **Correct Answer: D. Dorsal Column.**