[Freezing phenomenon in Parkinson disease]

"Freezing" is a sudden, unforeseen state of immobility occurring independently of L-Dopa dosage timing and often presents in connection with walking, speech and hand movements. The immobility results from deficits in initiating or simultaneously and sequentially executing movements, in correcting inappropriate movements or planning movements. However, since the progression of motor activity is strongly dependent upon external stimuli, the patient can overcome the freezing phenomena with the aid of certain stimuli or subjective strategies. No consistent relationships have been found with respect to age, length of illness, L-dopa dosis or L-dopa treatment. Neurotransmitter models to explain the freezing phenomena are: a noradrenalin deficiency in locus coeruleus or alternately a dopamine deficiency in substantia nigra, pars compacta, which can possibly be coupled with a GABA deficiency in substantia nigra, pars reticulata. In addition to optimal drug therapy, patients require physiotherapeutical and ergotherapeutical assistance to develop subjectively effective strategies in counteracting freezing during everyday activities.