Two unusual gait disturbances: astasia abasia and camptocormia

The physiatrist frequently encounters gait abnormalities in his daily practice. Commonly, there is an obvious organic basis for the disturbance. However, on rare occasions, the gait abnormality is the consequence of a functional conversion reaction. This represents both a diagnostic and therapeutic dilemma, in extreme cases leading to unnecessary diagnostic tests and their associated complications and costs. Early suspicion and knowledge of functional gait disorders may expedite the correct diagnosis and the institution of appropriate therapy, shortening hospital stay and eliminating unnecessary procedures. This case study reviews two patients with unique gait disturbances-astasia abasia and camptocormia. Astasia abasia is the inability to stand or walk in the absence of other neurologic abnormalities. Camptocormia is characterized by exaggerated trunk flexion of functional etiology. Both patients demonstrated rapid resolution of symptoms after psychiatric intervention.