Walking Backwards

[S-Hawkinson]

    
      Re: Walking Backwards
    


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Posted by CCF Neuro MD on August 12, 1997 at 20:24:45:

In Reply to: Walking Backwards posted by S. Hawkinson on July 15, 1997 at 19:47:02:

: My mother, aged 67, has experienced a movement disorder for almost a year.  
  Periodically, (sometimes every two or three months, sometimes many times
  in a month period) after standing up from a sitting position, she experiences
  involuntary backward walking.  She says she does not even realize she
  is moving backwards until she is stopped by some object (wall or furniture).
  I have seen this first hand recently.  I have literally had to forcefully pull
  her forward until she starts walking forward on her own.  Once or twice her
  legs have started to buckle and I have had to hold her under her arms.
  She has undergone cat scans, numerous tests, neurological exams.  No diagnosis
  has been made.  She was on Prozac and the thought was that the medication may
  somehow been responsible for the backward movement.  After being taken off
  Prozac approx. 4 months ago, she had not experienced any episodes until
  about two months ago (once) and last week (once).  
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Dear Susan:
Falling backwards sounds definitely organic in your mother's case. The sign is frequently observed in some parkinsonian syndromes (i.e., one of several conditions resembling Parkinson's disease), specifically progressive supranuclear palsy (PSP). PSP is a neurodegenerative condition like Parkinson's disease, but less common. Symptoms and signs include rigidity, slowness of movement, change in speech, difficulty swallowing, limitation of downward eye movement, gait difficulty, and cognitive difficulty.
Prozac and other SSRI antidepressants have been described to cause movement disorders such as parkinsonism akathisia (restlessness) and dystonia (twisted posturing), although less frequently than several other psychotropic medications. Although it is conceivable that Prozac caused the gait problem your mother has, it is equally possible that it unmasked an underlying neurodegenerative disorder.
I strongly recommend that your mother consult with a neurologist with expertise in movement disorders in an academic tertiary referral institution for an accurate diagnosis. In case she lives near Cleveland, I suggest that she see Dr. R. S. Burns at the Cleveland Clinic. The number to call for appointments is [phone], or [phone] toll free.
This information is for general medical education purposes only. Please consult with your physician for diagnostic and treatment options of your specific medical condition.