Brun’s ataxia
by Kalyan B Bhattacharyya, Kalyan Satish V

Atlas of Neurology—A Case-based Approach

by Satish V Khadilkar, Kalyan B Bhattacharyya
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Identify the gait abnormality and give the differential diagnosis. The patient assumes a posture of slight flexion with the feet placed wide apart and takes small, shuffling, hesitant steps. It takes the patient great effort to advance but surprisingly, they show remarkable improvement with minimal support while walking along with care-giver. In advanced stages, the patient makes only some stepping movements in one place, unable to move his feet and legs forward, which is known as ‘magnetic gait’, or the ‘gait ignition failure’. Turning is difficult, one foot moving while the other forms the pivot on which the patient rotates, the pivot sign. It is seen in frontal lobe disorders like, normal pressure hydrocephalus, Alzheimer’s disease, Binswanger’s disease, frontotemporal lobar dementia, advanced Parkinson’s disease, progressive supranuclear palsy, etc.

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