Interested in submitting an e–Pearl? Click here!
Brought to you by the Resident and Fellow Section of Neurology®.
February 14, 2012
Freezing of gait in an “off” state in patients with Parkinson disease is well recognized. Pronounced during turns and gait initiation, this symptom improves with dopaminergic medications. Less well known is the freezing of gait during the “on” state that more rarely occurs as a paradoxical complication of levodopa. Some characteristics that may help differentiate these is that “on” state freezing of gait worsens with increasing levodopa doses, occurs during open space walking just as often as during turning or initiation, and is associated with good control of other parkinsonian features.
1. Espay AJ, Fasano A, van Nuenen BFL, Payne MM, Snijders AH, Bloem BR. “On” state freezing of gait in Parkinson disease: A paradoxical levodopa–induced complication. Neurology 2012; 78: 454–457.
2. Ambani LM, Van Woert MH. Start hesitation–a side effect of long–term levodopa therapy. N Engl J Med 1973; 288: 1113–1115.
Submitted by: Jennifer E. Fugate, D.O.
Disclosures: Dr. Fugate serves on the editorial team for the Neurology® Resident and Fellow Section.
For more clinical pearls and other articles of interest to neurology trainees, visit www.neurology.org and click on the link to the Resident and Fellow Pages. Click here to visit the E–Pearl of the Week Archive.
Click here to listen to this week's Neurology® Podcast.