Gait Apraxia
Gait Apraxia
Gait apraxia is a name given to an inability to walk despite intact motor systems and sensorium. Patients with gait apraxia are often
hesitant, seemingly unable to lift their feet from the floor ("magnetic gait") or put one foot in front of the other. Arms may be held out at the sides to balance for fear of falling; fear may be so great that the patient sits in a chair gripping its sides. These phenomena may be observed with lesions of the frontal lobe and white matter connections, with or without basal ganglia involvement, for example in diffuse cerebrovascular disease and normal pressure hydrocephalus. A syndrome of isolated gait apraxia has been described with focal degeneration of the medial frontal lobes. In modern classifications of gait disorders, gait apraxia is subsumed into the categories of frontal gait disorder, frontal disequilibrium, and isolated gait ignition failure.
Gait apraxia is an important diagnosis to establish since those afflicted generally respond poorly, if at all, to physiotherapy; moreover, because both patient and therapist often become frustrated because of lack of progress, this form of treatment is often best avoided.
References
Nutt JG, Marsden CD, Thompson PD. Human walking and higherlevel gait disorders, particularly in the elderly. Neurology 1993; 43: 268-279
Rossor MN, Tyrrell PJ, Warrington EK, Thompson PD, Marsden CD, Lantos P. Progressive frontal gait disturbance with atypical Alzheimer’s disease and corticobasal degeneration. Journal ofNeurology, Neurosurgery and Psychiatry 1999; 67: 345-352
Cross References
