Case of the Week: 27th April 1999

from The Hong Kong Polytechnic University & Tuen Mun Hospital, Hong Kong

5 year old boy with spastic diplegia. Walks with the aid of bilateral AFOs and a K-walker.

As can be seen in the animation below, he demonstrates quite a marked assymetrical tonic neck reflex (ATNR).

The gait is somewhat stop-go, and there are occassional moments of "freezing", after which the ATNR seems to be associated with a new burst of activity.

He was examined before and 4 months after bilateral Botox injections to the gastrocnemius muscles.

Temporal-spatial Parameters

Velocity Cadence Stride Length Step Length Stance Duration
0.09 m/s 42 steps/min 0.26 m R = 15 cm; L = 11 cm R = 86%; L = 90%

QuickTime Movies

Unaided Gait With AFOs With K-Walker After Botox
Left side Left side Right side Right side
Front view     "freezing episode"
Back view Back view   Long

3D Gait Analysis results (Vicon 370 Version 2.6, full-body marker set, VCM kinematics)

Pre-Botox Left/Right/Normal    
Post-Botox Left/Right/Normal Left Variability Right Variability

 Pre/Post Comparison: Left ... Right

... points for discussion:

What people said...

Case prepared by Dr. Chris Kirtley & referred by Nerita Chan

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Maintained by Dr. Chris Kirtley, Andreas Kranzl
Last modified on 27th April. 1999.

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