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What to do when
Functional freezing of gait: lessons from compensation
  1. Jorik Nonnekes1,
  2. Marleen Tibben2,
  3. Lotte van de Venis3,
  4. Bastiaan R Bloem3
  1. 1Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Rehabilitation, Nijmegen, the Netherlands
  2. 2HSK Expertise Center Functional Movement Disorders Woerden, NL Mental Care Group, Hilversum, the Netherlands
  3. 3Radboud University Medical Centre; Donders Institute for Brain, Cognition and Behaviour; Department of Neurology, Nijmegen, Gelderland, the Netherlands
  1. Correspondence to Dr Jorik Nonnekes, Radboud University Medical Centre, Nijmegen, the Netherlands; jorik.nonnekes{at}radboudumc.nl

Abstract

We highlight a specific and hitherto poorly characterised phenotype of functional gait impairments: functional freezing of gait. Unique to the presented case is the use of compensation strategies, many of which at first sight might appear to hint towards the presence of freezing of gait typical of Parkinson’s disease or another form of Parkinsonism. Importantly, however, this patient’s compensation strategies involved various inconsistent and incongruent elements, supporting the diagnosis of a functional neurological disorder. Recognising the features of functional freezing also helps to appreciate better the classical manifestations of freezing of gait in Parkinson’s disease.

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  • REHABILITATION

Data availability statement

No data are available.

https://doi.org/10.1136/pn-2023-003853

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    Data availability statement

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    Footnotes

    • Twitter @basbloem

    • Contributors JN and BRB conceived the idea for this article and performed the neurological examination in this patient. JN drafted the first version of this article, with subsequent feedback from all other authors.

    • Funding The Radboudumc Centre of Expertise for Parkinson’s Disease & Movement Disorders was supported by a Center of Excellence Grant of the Parkinson’s Foundation.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed by Jon Stone, Edinburgh, UK.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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