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Transient dystonic toe-walking: differentiation from cerebral palsy and a rare explanation for some unexplained cases of idiopathic toe-walking

Published online by Cambridge University Press:  17 January 2006

Christopher J Newman
Affiliation:
Neuropaediatrics Unit, Department of Paediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Anne-Lise Ziegler
Affiliation:
Neuropaediatrics Unit, Department of Paediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Pierre-Yves Jeannet
Affiliation:
Neuropaediatrics Unit, Department of Paediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Eliane Roulet-Perez
Affiliation:
Neuropaediatrics Unit, Department of Paediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Thierry W Deonna
Affiliation:
Neuropaediatrics Unit, Department of Paediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
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Abstract

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.

Type
Original Articles
Copyright
2006 Mac Keith Press

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