Hyperkinetic gait disorders

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A hyperkinetic gait occurs in conditions such as Sydenham’s chorea, Huntington's disease and other forms of transient or persistent chorea, athetosis, and dystonia.(1-4) The abnormal movements may become more marked while the patient is walking, and the manifestations of the disease more evident. Walking may accentuate not only the hyperkinesias, but also the abnormalities of power and tone that accompany them. The choreic gait may appear grotesque, with dancing or prancing and abundant extraneous movement. It may look histrionic but is all too real.

The video shows a woman with a choreic gait, probably HD. Note the involuntary, irregular, jerky movements of the body and extremities, especially on the right side. There are also choreiform movements of the face.(5)

References

1. Campbell WW. DeJong's the neurologic examination, 7th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013.

2. Campbell WW. Clinical signs in neurology: a compendium. Philadelphia: Wolters Kluwer Health, 2016.

3. Delval A, Krystkowiak P, Delliaux M, Blatt JL, et al. Effect of external cueing on gait in Huntington's disease. Mov Disord. 2008;23:1446-52.

4. Pyo SJ, Kim H, Kim IS, Park YM, et al. Quantitative Gait Analysis in Patients with Huntington's Disease. J Mov Disord. 2017;10:140-144.

5. Video used by permission of Paul D. Larsen, M.D., University of Nebraska Medical Center and Suzanne S. Stensaas, Ph.D., University of Utah School of Medicine. Additional materials were drawn from resources provided by Alejandro Stern, Stern Foundation, Buenos Aires, Argentina; Kathleen Digre, M.D., University of Utah; and Daniel Jacobson, M.D., Marshfield Clinic, Wisconsin. The movies are licensed under a Creative Commons Attribution-NonCommerical-ShareAlike 2.5 License. Available at http://library.med.utah.edu/neurologicexam/html/gait_abnormal.html#13.