Pure Akinesia: Report of Two Cases

ABSTRACT

Parkinsonism is a clinical syndrome with constellation of resting tremor, rigidity, bradykinesia, and a variety of gait disturbances. Gait disturbances in parkinsonism include short-stepped festination, loss of postural reflexes, and freezing. In certain parkinsonian states such as progressive supranuclear palsy, gait disturbances are very prominent over other clinical signs of parkinsonism in the early stage. However, freezing is usually seen in the late course of parkinsonism. Recently, it has been recognized that some patients have prominent freezing in their early course of the disease, and not much of other parkinsonian signs. The pathologies need to be confirmed, but must be divers based on clinical description of the cases. We report two elderly men who presented with pure freezing. There was minimal short-term memory impairment in the second case, but no other signs of parkinsonism were present. Brief trial of L-dopa did not offer much benefit. Detailed clinical features and laboratory findings will be presented with discussion of the literatures.