title: Adult osteomalacia: a treatable cause of "fear of falling" gait.
abstract: A 65-year-old man was hospitalized with a gait disorder, obliging him to shuffle laterally(1) (video on the Neurology Web site at www.neurology.org) because of pain and proximal limb weakness. He had a gastrectomy for cancer 7 years previously, with severe vitamin D deficiency; parathormone and alkaline phosphatase were increased, with reduced serum and urine calcium and phosphate. There was reduced bone density (figure). He was mildly hypothyroid and pancytopenic. B12 and folate levels were normal. Investigation for an endocrine neoplasm (CT scan, Octreoscan) was negative. EMG of proximal muscles was typical for chronic myopathy; nerve conduction studies had normal results.
authors.affiliation: Department of Neurology, University of Turin, Italy. pao.ripe@hotmail.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Ripellino
authors.forename: Emanuela
authors.initials: E
authors.lastname: Terazzi
authors.forename: Enrica
authors.initials: E
authors.lastname: Bersano
authors.forename: Roberto
authors.initials: R
authors.lastname: Cantello
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use; D005239:Fear / Q000523:psychology; D005684:Gait / Q000187:drug effects; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000188:drug therapy* / Q000209:etiology; D010018:Osteomalacia / Q000150:complications* / Q000188:drug therapy*; D013974:Thyroxine / Q000627:therapeutic use*; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D014807:Vitamin D; D013974:Thyroxine; D002118:Calcium