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BMC Neurology

, 17:122

Movement disorders


BackgroundRare patients have been reported who developed a mixture of gait disturbances following a focal lesion in the frontal lobe. Thus, the exact location of frontal lesion responsible for a specific gait disturbance is not well defined.

Case presentationWe describe a 47-year-old man who experienced two episodes of paroxysmal freezing of gait of the right leg. During the attacks, he had no motor weakness, sensory change, or disequilibrium. He had past history of panic attacks. Recently, he had been under severe emotional stress. T2 and diffusion brain magnetic resonance imaging scans were normal. So far, the most likely clinical diagnosis might be functional freezing of gait. However, magnetic resonance angiography showed atherosclerosis in the proximal left anterior cerebral artery. Perfusion scans showed a delayed mean transit time in the left mesial frontal lobe. He developed two more attacks during the four months of follow up.

ConclusionsThe presented case illustrates that the mesial frontal lobe may be important in the pathophysiology of freezing of gait. We speculate that the supplementary motor area may generate a neuronal command for the initiation of locomotion that in our case may have been inhibited by a transient ischemia.

KeywordsMesial frontal lobe Transient ischemic attack Freezingof gait Locomotor block AbbreviationsANAAnti-nuclear antibodies

Anti-dsDNAAnti-double stranded DNA antibodies

C-ANCACytoplasmic anti-neutrophil cytoplasmic antibodies

CBCComplete blood counts

FOGFreezing of gait

MRMagnetic resonance

MRIMagnetic resonance imaging

P-ANCAPerinuclear anti-neutrophil cytoplasmic antibodies

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Autor: Hee Won Hwang - Seung Ha Lee - Chul Hyoung Lyoo - Myung Sik Lee


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