40 Questions
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?
Highest or higher level gait disorder
Which type of patients may experience frontal gait disorders according to the text?
Both older and younger patients
What might frontal gait disorders lead to a misdiagnosis of, particularly when tremor is also present?
Parkinson's disease
Which imaging studies have shown that frontal as well as parietal lesions may cause gait disorders?
Magnetic resonance imaging (MRI)
What is another term used in the literature to describe the same clinical syndrome as frontal gait disorder?
Subcortical/frontal dis equilibrium
Which group of gait disorders includes frontal as well as senile gait disorder, subcortical and frontal balance impairment, and isolated gait ignition failure?
Highest or higher level gait disorder
What type of lesions in the brain may induce gait problems by disrupting interhemispheric communication?
Frontal lesions
Which of the following has NOT been used in the literature to describe the same clinical syndrome as frontal gait disorder?
Basal ganglia lesions
What might a misdiagnosis of frontal gait disorder as Parkinson’s disease lead to?
Mismanagement of symptoms
What is another term for cautious gait as mentioned in the text?
Subcortical/frontal dis equilibrium
What is a possible cause of early problems with balance and gait in atypical parkinsonian syndromes?
Sensory ataxic gait disorder due to polyneuropathy
Which condition typically results in a gait disorder that is rigid akinetic as well as ataxic?
Multiple system atrophy (MSA)
What is a characteristic posture seen in patients with multiple system atrophy (MSA)?
Marked forward flexion of the neck
What is a cardinal symptom of the classical clinical type of progressive supranuclear palsy (PSP)?
Pure akinesia with freezing gait
What should patients with atypical parkinsonian syndromes primarily receive, according to the text?
Levodopa
Which type of dystonia usually has an onset in childhood or early adulthood?
Primary generalized dystonias
What may contribute to difficulties in walking in multiple system atrophy (MSA), even in early disease stages?
Orthostatic dysregulation
What is a characteristic movement seen in patients with progressive supranuclear palsy (PSP) while walking?
Flinging the legs forward in an uncontrolled manner
What may occur in Parkinson's disease (PD) as part of levodopa-induced dyskinesia?
Dystonic OFF symptoms
What is a possible cause of dystonic gait disorders?
Long-term treatment with dopamine receptor blocking drugs.
What is the term used to describe patients who have forgotten how to perform the act of walking?
Higher level gait disorder
What is a common cause of frontal gait disorders?
Basal ganglia lacunar infarction
What are some clinical problems associated with normal pressure hydrocephalus and the typical gait disorder?
Bladder problems and cognitive deficits
What is a characteristic feature of the gait in patients with frontal gait disorders?
Broad base
What is a common symptom in isolated gait ignition failure?
Inhibition of gait initiation
What may lead to backward falls in patients with frontal gait disorders?
Retropulsion
What is a characteristic feature of parkinsonian gait (rigid akinetic gait disorder)?
Impaired postural stability
What are the cardinal motor signs of Parkinson's disease?
Rest tremor and rigidity
In which patients do the symptoms initially affect only one side of the body and spread to the other side?
Patients with hemiparkinsonism
What is a characteristic feature of walking in patients with PD?
Walking may appear somewhat slow.
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?
Festination
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?
Freezing
What movement problem often occurs when asked to walk faster, where patients increase the step frequency rather than step length?
Bradykinesia
What is the term for the condition in PD where the feet are lifted less high than normally, leading to shuffling gait?
Festination
Which aspect of parkinsonian gait difficulties often responds to antiparkinsonian medication, but may contribute to existing orthostatic hypotension and make walking more insecure?
Gait disorder
What type of surgery mainly improves aspects of gait and posture associated with motor fluctuations and dyskinesia and which are responsive to levodopa?
Surgery for PD (deep brain stimulation)
What type of walking aid may be helpful for PD patients experiencing freezing episodes?
4-wheel walkers with brakes
What technique might be used to help overcome freezing blockages by providing rhythmical acoustic signals or visual impulses?
Laser line projecting stick
What is the dominant cause of falls in PD and is apparent on performing the pull or push test?
Impaired postural reflexes
What might worsen the gait of PD patients as it increases axial bradykinesia?
Dopamine agonists
Test your knowledge of the gait impairment characteristics in Parkinson's disease, including slow gait, reduced arm swing, stooped posture, and shuffling gait.
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