IJCNMH ARCpublishing

Issue: Issue 4 (2017)

Case Report

Primary Progressive Freezing: does it stand on its own?

Mafalda Seabra, Joana Guimar√£es, Carolina Garrett
Background: Freezing of gait is a gait disorder frequently attributed to Parkinsonism. When it occurs in isolation the term Primary Progressive Freezing can be applied. It is a rare finding and recently its validity was questioned. 
Case report: An 85-year-old man, without known vascular risk factors, came to our attention after falling several times. He complained of difficulty initiating gait and turning. Neurological examination in the initial consult unveiled freezing, particularly when initiating gait, without other overt signs of Parkinsonism. Levodopa+carbidopa+entacapone had already been introduced by another physician, and later rasagiline was added, but the latter was suspended due to absence of response. Imaging studies showed ischemic lesions in the posterior aspect of the left corona radiata and diffuse supratentorial and infratentorial atrophic lesions. 
Conclusion: Primary progressive freezing is a movement disorder that can be considered in the differential diagnosis of the Parkinson-Plus syndromes currently in need of better characterization. In this patient, after excluding other causes, it appears to be an adequate explanation for this unusual presentation.

Keywords: Freezing, Gait disorder, Parkinson-plus syndromes.

International Journal of Clinical Neurosciences and Mental Health 2017; 4:7
DOI: https://doi.org/10.21035/ijcnmh.2017.4.7
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