title: Frequencies of initial gait disturbances and falls in 100 Wilson's disease patients.
abstract: Wilson's disease (WD) is an inherited copper metabolism disorder. Gait disturbances may present with both extrapyramidal and cerebellar patterns. The frequencies of particular types of gait abnormalities have not been established; thus, the aim of the present study was to determine the occurrence of initial gait disturbances among our neurological WD patients. We analyzed 103 WD patients with neurological features at the time of diagnosis, between 2005 and 2014. The neurological and gait assessments were based on the Unified Wilson's Disease Score Scale (UWDRS), from which, we distinguished three main patterns of gait: dystonic, ataxic, or Parkinsonian. All types of gait impairment were assessed using four stages of severity (0=normal, 4=severe). We also obtained each patient's history of falls. Three patients had severe dystonia of limbs and were unable to stand or walk. Gait abnormalities were noted in 59% (59/100) of the remaining group of patients. The most common observed pattern was ataxic gait (45%; 27/59), which presented as impaired tandem in most cases. A mixed gait impairment was observed in 25% (15/59) of patients (ataxic, dystonic, and Parkinsonian, n=8; ataxic and Parkinsonian, n=7), a Parkinsonian gait in 18% (11/59), and a dystonic gait in 10% (6/59) of patients. Falls were noted in 35% of patients, but were occasionally observed in most cases. Gait disturbances are frequent in WD, and reflect the involvement of many brain structures.
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9 02957, Warsaw, Poland. Electronic address: kdziezyc@op.pl.
authors.forename: Karolina
authors.initials: K
authors.lastname: Dzieżyc
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9 02957, Warsaw, Poland. Electronic address: tomlit@medprakt.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Litwin
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9 02957, Warsaw, Poland. Electronic address: chabik@ipin.edu.pl.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Chabik
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Sobieskiego 9 02957, Warsaw, Poland; Department of Clinical and Experimental Pharmacology, Medical University of Warsaw, Banacha 1b 02097, Warsaw, Poland. Electronic address: czlonkow@ipin.edu.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Członkowska
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D018450:Disease Progression; D005260:Female; D005684:Gait / Q000502:physiology*; D006527:Hepatolenticular Degeneration / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index
keywords: Ataxic gait; Falls; Gait disturbances; Wilson's disease