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Frontal gait apraxia

Flavie Bompaire, Marion Lahutte, Stephane Buffat, Carole Soussain, Anne Emmanuelle Ardisson, Robert Terziev, Magali Sallansonnet-Froment, Thierry De Greslan, Sébastien Edmond, Mehdi Saad, Christophe Nioche, Thomas Durand, Sonia Alamowitch, Khe Hoang Xuan, Jean Yves Delattre, Jean Luc Renard, Hervé Taillia, Cyrus Chargari, Dimitri Psimaras, Damien Ricard
BACKGROUND: Radiation-induced leukoencephalopathy (RIL) is the most threatening delayed complication of cerebral radiotherapy (RT) and remains roughly defined by cognitive dysfunction associated with diffuse FLAIR MRI white matter hyperintensities after brain irradiation. We documented clinical, neuropsychological, and radiological aspects of RI in order to refine diagnostic criteria. METHODS: Patients referred to our center for deterioration in cognitive complaint at least 6 months after completing a focal or whole brain RT underwent a systematic cross-sectional assessment including clinical examination, neuropsychological tests, and a standardized MRI protocol...
December 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Takashi Kageyama, Haruo Yamanaka, Fumihiko Nakamura, Toshihiko Suenaga
A 63-year-old man presented with right-sided hemianopia and unsteady gait. Brain MRI revealed multiple hyperintense infarct-like lesions on diffusion-weighted images (DWI). Hyperintensity persisted in some of these lesions even after 6 weeks, although his symptoms were ameliorated then. The patient developed episodic dizziness and a transient event of apraxia at 18 weeks after the first episode. Brain MRI revealed additional hyperintense lesions on DWI, which persisted even after 7 weeks. Eventually, the patient manifested cauda equina syndrome 39 weeks after the first episode...
June 8, 2017: BMJ Case Reports
David Andrés González, Jason R Soble
OBJECTIVE: Creutzfeldt-Jakob disease (CJD) is a rare, rapidly progressive, and fatal neurodegenerative disease with neuropsychological sequelae. This study highlighted a rare presentation of CJD (e.g. corticobasal syndrome [CBS]), reviewed updated diagnostic criteria and procedures for CJD (e.g. diffusion weighted imaging [DWI], real-time quaking-induced conversion [RT-QuIC]), and discussed differential diagnoses. METHOD: Case report methodology focused on a 68-year-old, Hispanic, right-handed man with 11 years of education...
April 2017: Clinical Neuropsychologist
Inimioara Mihaela Cojocaru, V Ştefănescu, Daniela Traşcă, Adelina Şerban-Pereţeanu, B Chicoş, M Cojocaru
A 78-year-old Caucasian man was admitted in the Department of Neurology for visual disturbances, started two days before. The next day the patient experienced headache, fever and gait disturbances. He had hypertension, diabetes mellitus, an ischemic stroke 13 years ago, longstanding seronegative rheumatoid arthritis (17 years), polynodular goiter, right ischio-pubian fracture and right femoral vein thrombosis a year ago due to a car accident, since he is treated with oral anticoagulants associated to antiaggregant, hypotensors, statin and oral antidiabetics...
October 2015: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
Motomi Arai, Daisuke Takagi, Ryosuke Nagao
We present a case of callosal disconnection syndrome as a rare manifestation of acute disseminated encephalomyelitis (ADEM). A dextral 48-year-old Japanese woman received trivalent inactivated influenza vaccine in mid-November 2011. Twenty days later, she was found to be in a daze. Subsequently, she developed abnormal behavior and gait disturbance, and she was disoriented regarding time and place. Nystagmus and abnormal ocular movements were absent. Upper limb power was normal, whereas her lower limbs were mildly weak...
2014: Rinshō Shinkeigaku, Clinical Neurology
Jon B Toledo, Jon López-Azcárate, David Garcia-Garcia, Jorge Guridi, Miguel Valencia, Julio Artieda, Jose Obeso, Manuel Alegre, Maria Rodriguez-Oroz
OBJECTIVE: Oscillatory activity in the beta band is increased in the subthalamic nucleus (STN) of Parkinson's disease (PD) patients. Rigidity and bradykinesia are associated with the low-beta component (13-20Hz) but the neurophysiological correlate of freezing of gait in PD has not been ascertained. METHODS: We evaluated the power and coherence of the low- and high-beta bands in the STN and cortex (EEG) of PD patients with (p-FOG) (n=14) or without freezing of gait (n-FOG) (n=8) in whom electrodes for chronic stimulation in the STN had been implanted for treatment with deep brain stimulation...
April 2014: Neurobiology of Disease
Taku Homma, Mitsuaki Bandoh, Yoko Mochizuki, Naoaki Miura, Ryoichi Okiyama, Shiro Matsubara, Toshio Mizutani
We report the autopsy case of a 74-year-old woman. Onset of gait disturbance and left-side dominant bilateral motor disturbance in the patient led to bilateral progressive apraxia. This was associated with a decline in motor imagery, right-side dominant atrophy of the central sulcus region, and a decrease in cerebral blood flow during illness. She died of respiratory failure that had progressively worsened over a 9-year period. Pathologically, she exhibited right-side dominant cerebral atrophy; neuronal loss, gliosis, and astrocytic plaques were mainly present in the frontal lobe...
July 2013: Brain and Nerve, Shinkei Kenkyū No Shinpo
Sandra Okroglic, Catherine N Widmann, Horst Urbach, Philip Scheltens, Michael T Heneka
OBJECTIVE: Although the clinical manifestation and risk factors of cerebral microangiopathy (CM) remain unclear, the number of diagnoses is increasing. Hence, patterns of association among lesion topography and severity, clinical symptoms and demographic and disease risk factors were investigated retrospectively in a cohort of CM patients. METHODS: Patients treated at the Department of Neurology, University of Bonn for CM (n = 223; 98m, 125f; aged 77.32±9.09) from 2005 to 2010 were retrospectively enrolled...
2013: PloS One
J L Whitwell, J R Duffy, E A Strand, M M Machulda, M L Senjem, J L Gunter, K Kantarci, S D Eggers, C R Jack, K A Josephs
BACKGROUND AND PURPOSE: Primary progressive apraxia of speech, a motor speech disorder of planning and programming, is a tauopathy that has overlapping histological features with progressive supranuclear palsy. We aimed to compare, for the first time, atrophy patterns, as well as white matter tract degeneration, between these two syndromes. METHODS: Sixteen primary progressive apraxia of speech subjects were age- and gender-matched to 16 progressive supranuclear palsy subjects and 20 controls...
April 2013: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Ana B Rodríguez-Martínez, Adolfo López de Munain, Isidro Ferrer, Juan J Zarranz, Begoña Atarés, Nuria T Villagra, Jose M Arteagoitia, Joseba M Garrido, Ramón A Juste
UNLABELLED: HASH(0x559b3cfcd6a0) INTRODUCTION: The coexistence of different molecular types of classical protease-resistant prion protein in the same individual have been described, however, the simultaneous finding of these with the recently described protease-sensitive variant or variably protease-sensitive prionopathy has, to the best of our knowledge, not yet been reported. CASE PRESENTATION: A 74-year-old Caucasian woman showed a sporadic Creutzfeldt-Jakob disease clinical phenotype with reactive depression, followed by cognitive impairment, akinetic-rigid Parkinsonism with pseudobulbar syndrome and gait impairment with motor apraxia, visuospatial disorientation, and evident frontal dysfunction features such as grasping, palmomental reflex and brisk perioral reflexes...
2012: Journal of Medical Case Reports
Shigeto Nagao, Osamu Yokota, Reiko Nanba, Hiroshi Takata, Takashi Haraguchi, Hideki Ishizu, Chikako Ikeda, Naoya Takeda, Etsuko Oshima, Katsuaki Sakane, Seishi Terada, Yuetsu Ihara, Yosuke Uchitomi
We report an autopsy case of progressive supranuclear palsy (PSP) that clinically showed only slowly progressive and symmetric upper motor neuron syndrome over a disease course of 12 years. A female patient initially exhibited dysarthria at the age of 65, followed by gait disturbance and dysphagia. Neurological examination at age 67 disclosed pseudobulbar palsy, spastic gait, hyperreflexia, and presence of bilateral Hoffmann and Babinski signs. However, muscle atrophy, weakness, evidence of denervation on electromyography, vertical gaze palsy, parkinsonism, gait freezing, aphasia, speech apraxia, or dementia was not noted throughout the course...
December 15, 2012: Journal of the Neurological Sciences
Imre Szirmai
UNLABELLED: The "arteriosclerotic parkinsonism", which is called vascular parkinsonism (VP), was first described by Critchley'. The broad based slow gait, reduced stride lenght, start hesitation, freezing and paratonia was mentioned as "lower body parkinsonism" (LBP) which can be associated by slow speech, dysexecutive syndrome, and hand tremor of predominantly postural character. In VP the DAT-scan proved normal dopamine content of the striatum in contrast with Parkinson's disease (PD)...
November 30, 2011: Ideggyógyászati Szemle
Imen Kacem, Amina Gargouri, Mouna Ben-Djebara, Riadh Gouider
The clinical syndrome of pure akinesia (PA) is considered the third phenotype of progressive supranuclear palsy (PSP), and is characterized by freezing of gait and prominent speech disturbance without rigidity or tremor. It is frequently considered one of the dopamine resistant motor syndromes, and its pathophysiology remains unclear. We report a patient followed in the Department of Neurology of Razi Hospital, Tunisia, with PA with gait freezing (PAGF) with a frontal hypoperfusion on single photon emission CT and non-responsive dopa therapy...
January 2012: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
Paolo Frassanito, Luca D'Angelo, Luca Massimi, Libero Lauriola, Mariangela Novello, Concezio Di Rocco, Gianpiero Tamburrini
The exceptional case of a 19-month-old boy with an apparently isolated frontal lesion and a huge holocord neoplastic involvement, presenting with a subtly indolent preoperative course and a particularly tumultuous evolution, is reported. The diagnosis of embryonal tumour with abundant neuropil and true rosettes was posed.
April 2012: British Journal of Neurosurgery
Philip D Thompson
The precise anatomy and physiology of human walking remains poorly understood. The frontal lobes appear crucial, and, on the basis of clinical observation, contribute to the control of truncal motion, postural responses, and the maintenance of equilibrium and locomotion. The rich repertoire of frontal gait disorders gives some indication of this complexity. Variable combinations of disequilibrium with a wide stance base, increased body sway and falls, loss of control of truncal motion, locomotor disability with gait ignition failure, start hesitation, shuffling, and freezing are encountered in diseases of the frontal lobes...
2012: Handbook of Clinical Neurology
Richard Levy
Progressive supranuclear palsy (PSP) has been described as a clinical syndrome characterized by an impairment of voluntary control of gaze (supranuclear palsy), postural and gait instability, and behavioral and cognitive deficits including a frontal syndrome and psychic retardation. However, in the recent years, at least four other clinical forms of PSP have been recognized: PSP-Parkinsonism, "pure akinesia with gait freezing", PSP with cortico-basal syndrome, and PSP with speech apraxia. PSP-Parkinsonism mimics the signs and symptoms of idiopathic Parkinson's disease, including a significant reactivity to levodopa...
June 2011: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
Tomoyuki Mizuno, Katsuhiko Takeda
In this paper, we review the symptoms associated with damages to the frontal and/or temporal lobes. Similarities and differences between the symptoms observed after a stroke and in frontotemporal lobar degeneration are also discussed. Frontal lobe damages may lead to various apraxic disorders, including limb-kinetic, ideomotor, gait, buccofacial, and ocular motor apraxia. Language dysfunction can arise from perisylvian lesions as well as from extra-perisylvian regions. Broca's aphasia, Wernicke's aphasia, pure word deafness, and aphemia are typical examples of disorders caused by damages to the perisylvian region...
November 2009: Brain and Nerve, Shinkei Kenkyū No Shinpo
Maria Chiara Carboncini, Duccio Volterrani, Luca Bonfiglio, Gabriele Barsotti, Mauro Della Porta, Giuliano Mariani, Bruno Rossi
BACKGROUND: the so-called higher level gait disorders include several types of gait disorders in which there are no major modifications in strength, tone, sensitivity, coordination and balance. Brain activation sites related to walking have been investigated using SPECT in humans. The aim of the study was to investigate brain activation during walking in subjects with high-level gait disorders due to chronic subcortical vascular encephalopathy. SUBJECTS: twelve patients with a chronic vascular encephalopathy were enrolled in the study...
May 2009: Age and Ageing
J Ghika
Bipedal locomotion and fine motility of hand and larynx of humans introduced musculoskeletal adaptations, new pyramidal, corticostriatal, corticobulbar, nigrostriatal, and cerebellar pathways and expansions of prefrontal, cingular, parieto-temporal and occipital cortices with derived new brain capabilities. All selectively degenerate in aged homo sapiens following 16 syndromic presentations: (1) Parkinsonism: nigrostriatal control for fast automatic movements of hand, larynx, bipedal posture and gait ("simian gait and hand")...
November 2008: Medical Hypotheses
Etsuro Mori
The triad symptoms of idiopathic normal pressure hydrocephalus (iNPH), i.e., dementia, gait disturbance, and urinary incontinence may appear commonly in the elderly suffering from various brain diseases as well as in those with musculoskeletal disorders. It would not be easy to differentiate iNPH from other neurological diseases with musculoskeletal disorders in the elderly. Gait disturbance is an early and central clinical symptom, and its improvement after temporary removal of CSF and shunt surgery is the most notable...
March 2008: Brain and Nerve, Shinkei Kenkyū No Shinpo
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