Functional freezing of gait: lessons from compensation
Jorik Nonnekes1, Marleen Tibben2, Lotte van de Venis3
1Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Rehabilitation, Nijmegen, the Netherlands jorik.nonnekes@radboudumc.nl.
Practical Neurology
|November 10, 2023
Summary
This study describes functional freezing of gait, a rare gait impairment. The patient used unusual compensation strategies, distinguishing it from Parkinsonian gait disorders and aiding functional neurological disorder diagnosis.
Area of Science:
- Neurology
- Neuroscience
- Movement Disorders
Background:
- Functional gait impairments are often poorly characterized.
- Freezing of gait (FOG) is a common symptom in Parkinson's disease (PD) and Parkinsonism.
- Differentiating functional FOG from neurodegenerative FOG is clinically important.
Purpose of the Study:
- To describe a specific phenotype of functional gait impairment: functional freezing of gait (fFOG).
- To highlight the unique compensation strategies observed in fFOG.
- To differentiate fFOG from Parkinsonian FOG.
Main Methods:
- Case report detailing a patient with functional gait impairment.
- Clinical observation and analysis of patient's gait and compensation strategies.
- Differential diagnosis based on observed clinical features.
Main Results:
- The patient exhibited functional freezing of gait (fFOG).
- Observed compensation strategies were inconsistent and incongruent, atypical for Parkinsonism.
- These features supported a diagnosis of functional neurological disorder.
Conclusions:
- Functional freezing of gait is a distinct phenotype requiring careful clinical assessment.
- Inconsistent compensation strategies are key indicators differentiating fFOG from Parkinsonian FOG.
- Understanding fFOG enhances the recognition of classical FOG in Parkinson's disease.
