Functional gait disorders, clinical phenomenology, and classification

Area of Science:

• Neurology
• Movement Disorders

Background:

• Functional gait disorders (FGDs) are frequently encountered in patients evaluated for functional movement disorders (FMDs).
• Diagnosing and classifying FGDs presents challenges due to the potential for primary FGD or FMDs impacting gait.

Purpose of the Study:

• To investigate the prevalence and characteristics of functional gait disorders in patients with functional movement disorders.
• To differentiate between primary FGDs and FMDs that manifest during gait.

Main Methods:

• A retrospective analysis of clinical data and gait video recordings from 153 patients diagnosed with FMDs.
• Detailed evaluation of gait patterns and co-occurring FMD symptoms.

Main Results:

• 39.2% of patients had a primary FGD, with 8.5% presenting with isolated FGD.
• 34% of patients exhibited FMDs during otherwise normal gait; tremor and dystonia were common.
• Specific gait abnormalities like slow-hesitant gait and astasia-abasia were more frequent in FGD patients.

Conclusions:

• Abnormal gait in FMD patients can stem from primary FGDs or co-occurring FMDs affecting gait.
• Both scenarios are common and contribute to patient disability.
• Understanding these distinctions is crucial for accurate diagnosis and management.