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Psychogenic movement disorders (PMD) after war or mass vaccination was reported and well known disease entity already. However, we have seldom been met those patients because we don’t have any chance to experience of those events. Recently, influenza A (H1N1) spreads around world, and many countries have a program of mass vaccination of H1N1. Although PMD in adult is well characterized, childhood-onset PMD has not been extensively studied.
We present four children of psychogenic gait disorders (PGDs) after mass school vaccination of H1N1. They had fluctuating weakness and their prognosis was good. We confirmed all patients as PGD by placebo.
Our four cases have two common characteristics. One is that all were young and their prognosis was good. And the other is that all were induced their abnormal gait symptoms after mass school vaccination. We observed that mass PMD has a different characteristics comparing to personal PMD, and PMD in children is differ from adult onset PMD.
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The purpose of our study was to investigate gait dynamics and kinematics in patients with Parkinson’s disease (PD) and to correlate these features with the predominant clinical features and with the presence of the freezing of gait (FOG). We measured the temporospatial and kinematic parameters of gait in 30 patients with PD (M:F=12:18, age=68.43±7.54) using a computerized video motion analysis system.
We divided the subjects into subgroups: (1) tremor-dominant (TD) group and postural instability and gait disturbance (PIGD) group and (2) FOG group and non-FOG group. We compared the gait parameters between the subgroups.
The walking velocity and stride length were reduced significantly in the PIGD group compared to the TD group. The PIGD group showed a significantly reduced range of motion in the pelvic and lower extremity joints by kinematics. Stride time variability was significantly increased and the pelvic oblique range was significantly reduced in the freezing gait disorder group.
Our findings suggest that there are differences in the perturbation of the basal ganglia-cortical circuits based on major clinical features. The reduction of the pelvic oblique range of motion may be a compensatory mechanism for postural instability and contributes to stride time variability in patients with FOG.
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