Reversible freezing of gait caused by dural arteriovenous fistula and congestion of the globus pallidus

Mov Disord. 2012 Nov;27(13):1690-3. doi: 10.1002/mds.25184. Epub 2012 Oct 18.

Abstract

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.

Publication types

  • Case Reports

MeSH terms

  • Central Nervous System Vascular Malformations / complications*
  • Central Nervous System Vascular Malformations / pathology*
  • Cerebral Angiography
  • Follow-Up Studies
  • Gait Disorders, Neurologic / etiology*
  • Globus Pallidus / diagnostic imaging
  • Globus Pallidus / pathology*
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Tomography, X-Ray Computed