Bent knees and tiptoeing: late manifestations of end-stage Parkinson's disease

Mov Disord. 2004 Nov;19(11):1325-8. doi: 10.1002/mds.20187.

Abstract

We describe a unique gait phenomenon of bent knees in 9 patients with idiopathic Parkinson disease (mean age, 73.1 +/- 11.1 years), 3 of whom also manifested tiptoeing. The bent-knee posture appeared only during ambulation; in the recumbent position, full or nearly full extension was possible in all patients. The abnormality emerged after long-standing disease (6-23 years from onset) and failed to respond to dopaminergic treatment. Most of the patients also had bent spine (camptocormia). The pathogenesis of these phenomena are unknown, but they might represent a rare type of dystonia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / therapeutic use
  • Disease Progression
  • Dystonia / diagnosis*
  • Female
  • Gait Disorders, Neurologic / diagnosis*
  • Gait Disorders, Neurologic / drug therapy
  • Humans
  • Knee
  • Male
  • Middle Aged
  • Neurologic Examination*
  • Parkinson Disease / diagnosis*
  • Posture*
  • Prognosis
  • Toes
  • Treatment Failure

Substances

  • Antiparkinson Agents