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Bruns apraxia, or frontal ataxia is a gait apraxia found in patients with bilateral frontal lobe disorders. It is characterised by an inability to initiate the process of walking, despite the power and coordination of the legs being normal when tested in the seated or lying position. The gait is broad-based with short steps with a tendency to fall backwards. It was originally described in patients with frontal lobe tumours, but is now more commonly seen in patients with cerebrovascular disease.〔William Pryse-Phillips. ''Companion to clinical neurology''. Oxford University Press, 2003, page 136. ISBN 978-0-19-515938-7.〕 It is named after Ludwig Bruns.〔Barry G. Firkin, Judith A. Whitworth. ''Dictionary of Medical Eponyms.'' Informa Health Care, 2001, page 51. ISBN 978-1-85070-333-4.〕 ==Symptoms== Unlike ataxias of cerebellar origin, Bruns apraxia exhibits many frontal lobe ataxia characteristics, with some or all present. *Difficulty in initiating movement *Poor truncal mobility *Falls due to minor balance disturbances *Greatly hindered postural responses *Characteristic magnetic gait, the inability to raise one's foot off of the floor. *Wide base, poor balance control when in stance *Short stride *En bloc turns Often patients with frontal lobe ataxia may experience minute cognitive changes that accompany the gait disturbances, such as frontal dementia and presentation of frontal release signs (Plantar reflex). Urinary incontinence may also be present.〔Frontal lobe ataxia; Thompson, PD. Handbook Clinical Neurology. 2012;103:619-22. doi: 10.1016/B978-0-444-51892-7.00044-9.〕 〔Ataxia: Physical Therapy and Rehabilitation Applications for Ataxic Patients, 2014. http://cirrie.buffalo.edu/encyclopedia/en/article/112/#s4〕 Bruns apraxia can be distinguished from Parkinsonian ataxia and cerebellar ataxia in a number of ways. Patients typically afflicted with Parkinsonian ataxia typically have irregular arm swing, a symptom not typically present in frontal ataxia. Walking stride in cerebellar ataxia varies dramatically, accompanied by erratic foot placement and sudden, uncontrolled lurching, not generally characteristic of Bruns apraxia.〔Jody Corey-Bloom; Ronald B. David. “Clinical Adult Neurology”. Demos Medical Publishing, 2009, 3rd ed, pages 115-116. ISBN 978-1-933864-35-8.〕 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Bruns apraxia」の詳細全文を読む スポンサード リンク
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