Transient dystonic toe-walking: differentiation from cerebral palsy and a rare explanation for some unexplained cases of idiopathic toe-walking

Dev Med Child Neurol. 2006 Feb;48(2):96-102. doi: 10.1017/S0012162206000223.

Abstract

We report on seven children (five males, two females) who presented with marked, often asymmetrical, toe-walking from onset of independent walking, associated with abnormal foot postures and increased tone at the ankles with characteristics of dystonia. Most of the children had presented with unusual pre-walking locomotion and a mild delay in independent walking. They did not fit into the usual categories of 'habitual' toe-walking or congenital short tendo calcaneus but nor did they have the clinical signs of spastic diplegia or of a peripheral neuromuscular disease. Normalization occurred progressively in the second to fourth years of life. The children were re-examined several years later (1 to 11y) and were normal. We believe that their persistent toe-walking corresponded to a variant of 'transient focal dystonia of infancy'. Knowledge of its existence may justify a period of observation without special investigations, surgery, or casting.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Cerebral Palsy / diagnosis*
  • Child
  • Child Development
  • Child, Preschool
  • Diagnosis, Differential
  • Dystonia / diagnosis*
  • Dystonia / etiology*
  • Female
  • Follow-Up Studies
  • Foot
  • Gait Disorders, Neurologic / diagnosis*
  • Gait Disorders, Neurologic / etiology*
  • Humans
  • Infant
  • Male
  • Posture
  • Remission, Spontaneous
  • Walking