**Question:** Unilateral high stepping gait is seen in -

A. Spinal cord injury
B. Brainstem stroke
C. Cerebral palsy
D. Poliomyelitis

**Core Concept:**
Unilateral high stepping gait is a clinical sign characterized by elevating the contralateral leg during walking, resulting from spinal cord or brainstem lesions causing a loss of proprioception and coordination of leg movements.

**Why the Correct Answer is Right:**
Correct answer B (Brainstem stroke) is chosen because a brainstem stroke can lead to disruption of the corticospinal tract and the corticobulbar tract, causing a decrease in sensory and motor function. This disruption impairs proprioception and coordination, resulting in the high stepping gait pattern.

**Why Each Wrong Option is Incorrect:**
A. Spinal cord injury (A) can cause high stepping, but it is more commonly associated with a complete lesion affecting both corticospinal and proprioceptive pathways, leading to a flaccid gait pattern rather than the elevated high stepping gait seen in brainstem stroke.

C. Cerebral palsy (C) usually presents with a spastic gait pattern, characterized by increased muscle tone, reflexes, and clonus, rather than the elevated gait pattern seen in brainstem stroke.

D. Poliomyelitis (D) predominantly affects the lower motor neurons, leading to a flaccid gait pattern (paralysis) rather than the elevated gait pattern seen in brainstem stroke.

**Clinical Pearl:** Unilateral high stepping gait should raise suspicion for a brainstem stroke, as it can be the presenting sign in such cases, particularly when associated with other neurological deficits. Prompt evaluation and intervention are crucial in stroke management to improve patient outcomes.