Parkinson's Disease Gait Impairment
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Questions and Answers

What term did Nutt, Marsden, and Thompson coin in 1993 to describe gait or balance problems not explained by peripheral, pyramidal, cerebellar, or basal ganglia lesions?

  • Lower body parkinsonism
  • Highest or higher level gait disorder (correct)
  • Marche à petits pas
  • Gait apraxia
  • Which type of patients may experience frontal gait disorders according to the text?

  • Only younger patients
  • Only older patients
  • Patients with peripheral lesions
  • Both older and younger patients (correct)
  • What might frontal gait disorders lead to a misdiagnosis of, particularly when tremor is also present?

  • Alzheimer's disease
  • Stroke
  • Parkinson's disease (correct)
  • Cerebral palsy
  • Which imaging studies have shown that frontal as well as parietal lesions may cause gait disorders?

    <p>Magnetic resonance imaging (MRI)</p> Signup and view all the answers

    What is another term used in the literature to describe the same clinical syndrome as frontal gait disorder?

    <p>Subcortical/frontal dis equilibrium</p> Signup and view all the answers

    Which group of gait disorders includes frontal as well as senile gait disorder, subcortical and frontal balance impairment, and isolated gait ignition failure?

    <p>Highest or higher level gait disorder</p> Signup and view all the answers

    What type of lesions in the brain may induce gait problems by disrupting interhemispheric communication?

    <p>Frontal lesions</p> Signup and view all the answers

    Which of the following has NOT been used in the literature to describe the same clinical syndrome as frontal gait disorder?

    <p>Basal ganglia lesions</p> Signup and view all the answers

    What might a misdiagnosis of frontal gait disorder as Parkinson’s disease lead to?

    <p>Mismanagement of symptoms</p> Signup and view all the answers

    What is another term for cautious gait as mentioned in the text?

    <p>Subcortical/frontal dis equilibrium</p> Signup and view all the answers

    What is a possible cause of early problems with balance and gait in atypical parkinsonian syndromes?

    <p>Sensory ataxic gait disorder due to polyneuropathy</p> Signup and view all the answers

    Which condition typically results in a gait disorder that is rigid akinetic as well as ataxic?

    <p>Multiple system atrophy (MSA)</p> Signup and view all the answers

    What is a characteristic posture seen in patients with multiple system atrophy (MSA)?

    <p>Marked forward flexion of the neck</p> Signup and view all the answers

    What is a cardinal symptom of the classical clinical type of progressive supranuclear palsy (PSP)?

    <p>Pure akinesia with freezing gait</p> Signup and view all the answers

    What should patients with atypical parkinsonian syndromes primarily receive, according to the text?

    <p>Levodopa</p> Signup and view all the answers

    Which type of dystonia usually has an onset in childhood or early adulthood?

    <p>Primary generalized dystonias</p> Signup and view all the answers

    What may contribute to difficulties in walking in multiple system atrophy (MSA), even in early disease stages?

    <p>Orthostatic dysregulation</p> Signup and view all the answers

    What is a characteristic movement seen in patients with progressive supranuclear palsy (PSP) while walking?

    <p>Flinging the legs forward in an uncontrolled manner</p> Signup and view all the answers

    What may occur in Parkinson's disease (PD) as part of levodopa-induced dyskinesia?

    <p>Dystonic OFF symptoms</p> Signup and view all the answers

    What is a possible cause of dystonic gait disorders?

    <p>Long-term treatment with dopamine receptor blocking drugs.</p> Signup and view all the answers

    What is the term used to describe patients who have forgotten how to perform the act of walking?

    <p>Higher level gait disorder</p> Signup and view all the answers

    What is a common cause of frontal gait disorders?

    <p>Basal ganglia lacunar infarction</p> Signup and view all the answers

    What are some clinical problems associated with normal pressure hydrocephalus and the typical gait disorder?

    <p>Bladder problems and cognitive deficits</p> Signup and view all the answers

    What is a characteristic feature of the gait in patients with frontal gait disorders?

    <p>Broad base</p> Signup and view all the answers

    What is a common symptom in isolated gait ignition failure?

    <p>Inhibition of gait initiation</p> Signup and view all the answers

    What may lead to backward falls in patients with frontal gait disorders?

    <p>Retropulsion</p> Signup and view all the answers

    What is a characteristic feature of parkinsonian gait (rigid akinetic gait disorder)?

    <p>Impaired postural stability</p> Signup and view all the answers

    What are the cardinal motor signs of Parkinson's disease?

    <p>Rest tremor and rigidity</p> Signup and view all the answers

    In which patients do the symptoms initially affect only one side of the body and spread to the other side?

    <p>Patients with hemiparkinsonism</p> Signup and view all the answers

    What is a characteristic feature of walking in patients with PD?

    <p>Walking may appear somewhat slow.</p> Signup and view all the answers

    What term is used to describe the gait pattern in PD where patients develop a propensity to lean forward while walking, associated with increased step frequency, reduced stride length, and bent truncal posture?

    <p>Festination</p> Signup and view all the answers

    What is a common difficulty experienced by PD patients related to turning or approaching obstacles, characterized by start failure or a complete stop while walking?

    <p>Freezing</p> Signup and view all the answers

    What movement problem often occurs when asked to walk faster, where patients increase the step frequency rather than step length?

    <p>Bradykinesia</p> Signup and view all the answers

    What is the term for the condition in PD where the feet are lifted less high than normally, leading to shuffling gait?

    <p>Festination</p> Signup and view all the answers

    Which aspect of parkinsonian gait difficulties often responds to antiparkinsonian medication, but may contribute to existing orthostatic hypotension and make walking more insecure?

    <p>Gait disorder</p> Signup and view all the answers

    What type of surgery mainly improves aspects of gait and posture associated with motor fluctuations and dyskinesia and which are responsive to levodopa?

    <p>Surgery for PD (deep brain stimulation)</p> Signup and view all the answers

    What type of walking aid may be helpful for PD patients experiencing freezing episodes?

    <p>4-wheel walkers with brakes</p> Signup and view all the answers

    What technique might be used to help overcome freezing blockages by providing rhythmical acoustic signals or visual impulses?

    <p>Laser line projecting stick</p> Signup and view all the answers

    What is the dominant cause of falls in PD and is apparent on performing the pull or push test?

    <p>Impaired postural reflexes</p> Signup and view all the answers

    What might worsen the gait of PD patients as it increases axial bradykinesia?

    <p>Dopamine agonists</p> Signup and view all the answers

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