Email updates

Keep up to date with the latest news and content from BMC Neurology and BioMed Central.

Open Access Case report

Acute transient freezing of gait in a patient with posterior reversible encephalopathy syndrome

Asuka Nakajima1, Yuji Ueno1*, Hideki Shimura1, Taiki Kambe1, Kenya Nishioka1, Nobutaka Hattori2 and Takao Urabe1

Author Affiliations

1 Department of Neurology, Juntendo University Urayasu Hospital, 2-1-1 Tomioka, Urayasu, Chiba 279-0021, Japan

2 Department of Neurology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo, Tokyo 113-8421, Japan

For all author emails, please log on.

BMC Neurology 2013, 13:79  doi:10.1186/1471-2377-13-79

Published: 9 July 2013

Abstract

Background

Posterior reversible encephalopathy syndrome (PRES) is a transient clinical and neuroradiologic syndrome caused by cerebral vasogenic edema. Various reversible neurologic symptoms were shown in patients with PRES. Freezing of gait (FOG) is mainly observed in neurodegenerative diseases.

Case presentation

We report a 43-year-old man, with undergoing hemodialysis therapy for chronic renal failure, had mild elevation of blood pressure. His consciousness level suddenly deteriorated, and brain MRI demonstrated hyperintense lesions in the bilateral basal ganglia on fluid-attenuated inversion recovery images, diffusion-weighted images, and apparent diffusion coefficient maps. After improvement of disturbance of consciousness, he showed FOG accompanied by bradykinesia and postural instability. His FOG spontaneously improved concurrently with alleviation of basal ganglionic lesions on follow-up MRI.

Conclusions

It is suggested that vasogenic edema on bilateral basal ganglia associated with PRES can cause acute transient FOG.

Keywords:
Posterior reversible encephalopathy syndrome; Freezing of gait; Parkinsonism; Vasogenic edema; Hemodialysis