1. Astasia without abasia due to peripheral neuropathy
- Author
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Mitsuru Kawamura, Yorio Koguchi, Masashi Nakajima, and Keizo Hirayama
- Subjects
Adult ,Male ,medicine.medical_specialty ,Weakness ,Flaccid paralysis ,Adolescent ,Posture ,Neurological disorder ,Apraxia ,Central nervous system disease ,Arts and Humanities (miscellaneous) ,medicine ,Humans ,Child ,Gait ,Movement Disorders ,Abasia ,business.industry ,Peripheral Nervous System Diseases ,Middle Aged ,medicine.disease ,Peripheral neuropathy ,medicine.anatomical_structure ,Conversion Disorder ,Physical therapy ,Female ,Neurology (clinical) ,medicine.symptom ,Ankle ,business - Abstract
Objective: To describe an unusual symptom characterized by an inability to stand still despite the ability to walk in eight patients with paraparesis due to peripheral neuropathy. Design: Case series during the past 18 years. Setting: Referral center. Patients: Six patients with acute or subacute polyneuropathies recovering from flaccid paralysis of the lower limbs and two patients with chronic progressive polyneuropathy for more than 10 years were studied. Weakness around the ankle joints was profound, while muscle strength around the hip joints was well recovered or preserved. Main Outcome Measures: Standing and walking were recorded and reviewed on videotape or motion pictures. Spectral content of postural sway was analyzed in three recent cases. Results: The symptom was transient in acute or subacute cases and was continual in chronic cases. The patients were compelled to take a series of steps forward and backward while standing until they initiated locomotion. They swayed rapidly around the hip joints before stepping. The anteroposterior component of postural sway in three patients had frequency peaks around 1 Hz. Conclusion: We have termed this symptom astasiawithout abasia, orstilts phenomenon, in which maintenance of the body mass depends on a moving base of support. Both an abnormal pattern of postural movements and defective somatosensory feedback for postural stabilization may be responsible for the symptom.
- Published
- 1994