Falls and freezing of gait in Parkinson's disease: A review of two interconnected, episodic phenomena

Authors

  • Bastiaan R. Bloem MD, PhD,

    Corresponding author
    1. Department of Neurology, University Medical Centre St. Radboud, Nijmegen, The Netherlands
    • Department of Neurology, 326, University Medical Centre St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands
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  • Jeffrey M. Hausdorff PhD,

    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Centre, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
    2. Division on Aging, Harvard Medical School, Boston, Massachusetts, USA
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  • Jasper E. Visser MD,

    1. Department of Neurology, University Medical Centre St. Radboud, Nijmegen, The Netherlands
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  • Nir Giladi MD

    1. Movement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Centre, Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Abstract

Falls and freezing of gait are two “episodic” phenomena that are common in Parkinson's disease. Both symptoms are often incapacitating for affected patients, as the associated physical and psychosocial consequences have a great impact on the patients' quality of life, and survival is diminished. Furthermore, the resultant loss of independence and the treatment costs of injuries add substantially to the health care expenditures associated with Parkinson's disease. In this clinically oriented review, we summarise recent insights into falls and freezing of gait and highlight their similarities, differences, and links. Topics covered include the clinical presentation, recent ideas about the underlying pathophysiology, and the possibilities for treatment. A review of the literature and the current state-of-the-art suggests that clinicians should not feel deterred by the complex nature of falls and freezing of gait; a careful clinical approach may lead to an individually tailored treatment, which can offer at least partial relief for many affected patients. © 2004 Movement Disorder Society

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