Erschienen in:
01.04.2020 | Original Article
Functional gait disorders, clinical phenomenology, and classification
verfasst von:
José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Joseph Jankovic
Erschienen in:
Neurological Sciences
|
Ausgabe 4/2020
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Abstract
Background
Functional gait disorders (FGDs) are relatively common in patients presenting for evaluation of a functional movement disorder (FMD). The diagnosis and classification of FGDs is complex because patients may have a primary FGD or a FMD interfering with gait.
Methods
We performed a detailed evaluation of clinical information and video recordings of gait in patients diagnosed with FMDs.
Results
We studied a total of 153 patients with FMDs, 68% females, with a mean age at onset of 36.4 years. A primary FGD was observed in 39.2% of patients; among these patients, 13 (8.5%) had an isolated FGD (a gait disorder without other FMDs). FMDs presented in 34% of patients with otherwise normal gait. Tremor was the most common FMD appearing during gait, but dystonia was the most common FMD interfering with gait. Patients with FGD had a higher frequency of slow-hesitant gait, astasia-abasia, bouncing, wide-based gait and scissoring compared with patients with FMDs occurring during gait. Bouncing gait with knee buckling was more frequently observed in patients with isolated FGD (P = 0.017). Patients with FGDs had a trend for higher frequency of wheelchair dependency (P = 0.073) than those with FMDs interfering with gait.
Conclusions
Abnormal gait may be observed as a primary FGD or in patients with other FMDs appearing during gait; both conditions are common and may cause disability.