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Topic Frontal Gate Disorder or Parkinson's Go to previous topic Go to next topic Go to higher level

By Lynnie On 2010.01.21 13:28
My friend who is 80 years old has been having problems with walking and balance.
She was diagnosed by two doctors. The first one said that it was Parkinson's in the lower body, but now another doctor said that it is a Frontal Gate disorder.
Have you heard of this? They say it's a very slow process and medication doesn't help.
When she walks, she can barely move her legs and it is a very slow process to move around. Her husband gets all of the meals and does the laundry and cleaning. She fell down the stairs last summer on her bum which didn't help. The doctor told her not to use the stairs by herself and if she falls again, she'll end up in a nursing home.

Is there anything that might help her in the way of medication or exercises?

By Lynnie On 2010.01.21 13:35
Sorry it should say Gait, not Gate.

By LOHENGR1N On 2010.01.21 16:25
Lynnie, I typed frontal gait disorder in my browser, a number of sites came up. Two are below;

http://www.Merck.com/mkgr/mmg/sec2/ch21/ch21a.jsp

http://knol.google.com/k/gait-disorders-in-the-elderly#

The following is cut and pasted from the second site;

Patients with frontal dysfunction may repeat the same words or actions over and over again (perseveration) and they lack flexibility of thought and action so that they stay on one track and cannot copy a series of different hand postures. Certain reflexes help the clinician to diagnose a frontal disorder: the patient may involuntarily grasp the examiner’s hand or fingers (grasp reflex), and scraping the palm results in puckering of the chin (palmo-mental reflex). They may have memerory disturbances and personality changes.

Characteristic Gaits:

Various types of gait disorders are produced by frontal lobe dysfunction

Ignition failure: The inability to get started. The patient takes a few hesitant steps on the spot when attempting to initiate ambulation. Once this initial difficulty has passed the gait is normal.

Classical frontal gait disorder: Ignition failure as above, but thereafter the gait is narrow based, with small steps and frequent stops and starts.

Frontal ataxia: The gait is bizarre and incoordinated. The explanation for this seemingly cerebellar-like syndrome is the strong influence exerted by the frontal lobes on the cerebellum by a tract called the “fronto-ponto-cerebellar tract” which describes exactly where it goes; disordered frontal control leads to disordered cerebellar function.

Lower Half Parkinsonism: The gait is as described as in classical frontal gait disorder, but the arms are not affected; the legs don’t work normally, but the arms pump furiously. White matter disease secondary to microvascular disease in the frontal lobe is the explanation.

I hope this helps. Take care, best of luck and hang in there.

By Lynnie On 2010.01.21 21:46
Thanks. It sounds like she has the classic frontal gait disorder where she takes small steps and stops and starts. I was hoping there was a medication that would help.


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