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Reversible freezing of gait caused by dural arteriovenous fistula and congestion of the globus pallidus
Author(s) -
Shahar Tal,
Gadoth Avi,
Nossek Erez,
Giladi Nir,
Ram Zvi,
Maimon Shimon
Publication year - 2012
Publication title -
movement disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.352
H-Index - 198
eISSN - 1531-8257
pISSN - 0885-3185
DOI - 10.1002/mds.25184
Subject(s) - medicine , arteriovenous fistula , parkinsonism , globus pallidus , gait , magnetic resonance imaging , edema , radiology , surgery , basal ganglia , pathology , physical medicine and rehabilitation , central nervous system , disease
Background: Freezing of gait (FOG) is defined as an episodic inability to generate effective stepping in the absence of any known cause other than parkinsonism or high‐level gait disorders. Methods: We present a 59‐year‐old male with acute, progressive episodes of FOG. Imaging studies revealed a dural arteriovenous fistula (DAVF) associated with edema of the globus pallidus interna (GPi). Cerebral angiography confirmed the diagnosis of DAVF and demonstrated an occluded straight sinus and a retrograde blood flow of deep cerebral veins. Results: After endovascular closure of the DAVF, a major improvement of FOG was observed concomitant with striking near resolution of GPi congestion. Conclusions: This reversal of the clinical course, correlated with changes in imaging studies, suggests a major role of the GPi in the pathology of FOG. © 2012 Movement Disorder Society