Transient dystonic toe-walking: differentiation from cerebral palsy and a rare explanation for some unexplained cases of idiopathic toe-walking.
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.
Newman
Christopher J
CJ
Neuropaediatrics Unit, Department of Paediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Ziegler
Anne-Lise
AL
Jeannet
Pierre-Yves
PY
Roulet-Perez
Eliane
E
Deonna
Thierry W
TW
D000293:Adolescent; D017668:Age of Onset; D002547:Cerebral Palsy / Q000175:diagnosis*; D002648:Child; D002657:Child Development; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004421:Dystonia / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D005528:Foot; D020233:Gait Disorders, Neurologic / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D007223:Infant; D008297:Male; D011187:Posture; D012075:Remission, Spontaneous; D016138:Walking