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Paroxysmal freezing of gait in a patient with mesial frontal transient ischemic attacks

 Hee Won Hwang  ;  Seung Ha Lee  ;  Chul Hyoung Lyoo  ;  Myung Sik Lee 
 BMC Neurology, Vol.17(1) : 122, 2017 
Journal Title
 BMC Neurology 
Issue Date
Brain/diagnostic imaging ; Frontal Lobe/diagnostic imaging* ; Gait Disorders, Neurologic/etiology* ; Humans ; Ischemic Attack, Transient/complications* ; Locomotion ; Magnetic Resonance Imaging ; Male ; Middle Aged
Freezingof gait ; Locomotor block ; Mesial frontal lobe ; Transient ischemic attack
BACKGROUND: Rare patients have been reported who developed a mixture of gait disturbances following a focal lesion in the frontal lobe. Thus, the exact location of frontal lesion responsible for a specific gait disturbance is not well defined. CASE PRESENTATION: We describe a 47-year-old man who experienced two episodes of paroxysmal freezing of gait of the right leg. During the attacks, he had no motor weakness, sensory change, or disequilibrium. He had past history of panic attacks. Recently, he had been under severe emotional stress. T2 and diffusion brain magnetic resonance imaging scans were normal. So far, the most likely clinical diagnosis might be functional freezing of gait. However, magnetic resonance angiography showed atherosclerosis in the proximal left anterior cerebral artery. Perfusion scans showed a delayed mean transit time in the left mesial frontal lobe. He developed two more attacks during the four months of follow up. CONCLUSIONS: The presented case illustrates that the mesial frontal lobe may be important in the pathophysiology of freezing of gait. We speculate that the supplementary motor area may generate a neuronal command for the initiation of locomotion that in our case may have been inhibited by a transient ischemia.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Lyoo, Chul Hyoung(류철형) ORCID logo https://orcid.org/0000-0003-2231-672X
Lee, Myung Sik(이명식) ORCID logo https://orcid.org/0000-0002-8413-1854
Lee, Seung Ha(이승하)
Hwang, Hee Won(황희원)
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