Leg stereotypy syndrome: phenomenological and quantitative analysis | Journal of Neurology – Springer

Background

Leg stereotypy syndrome (LSS) is a very common, yet underrecognized condition. The pathophysiology of the condition is not well understood.

Objective

To evaluate and describe the visual kinematic characteristics of the repetitive leg movements in individuals with LSS.

Methods

In this study, we identified and videotaped individuals diagnosed with LSS at the Parkinson’s Disease Center and Movement Disorders Clinic, Baylor College of Medicine, Houston, Texas between 2000 and 2023. Only patients with LSS and without any co-morbidities were included in the study. Their medical records were carefully reviewed, and the demographic and clinical data were entered into a database. Video recordings of the repetitive leg movements were then analyzed using TremAn software.

Results

We identified 14 individuals with LSS who were videotaped at our center. The videos of the 5 cases were too brief and therefore not suitable for TremAn quantitative analysis. The remaining 9 individuals exhibited regular rhythmic oscillations of the legs. Among these, two individuals displayed rhythmic movements only in video segments where their legs were in crossed positions. The other 7 individuals had regular rhythmic oscillations, always with the toes resting on the floor with the heels raised. Frequency analysis showed values between 4.5 and 6.5 Hz, fairly consistent with a variance below 0.5 Hz in individual cases. The oscillation frequency changed from 5.7 Hz to 2.7 Hz while standing.

Conclusion

In this study, 6 of 9 individuals with LSS showed 4.5–6.5 Hz regular rhythmic leg movements. Studies involving a larger LSS population with additional electrophysiological evaluations are needed to obtain further insights into this common movement disorder.

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Authors and Affiliations

1. Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, 77030-4202, USA

   Abdullah Yasir Yilmaz & Joseph Jankovic

2. Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic

   Evzen Ruzicka

Contributions

1. Research project: A. Conception, B. Organization, C. Execution; 2. Statistical analysis A. Design, B. Execution, C. Review and Critique; 3. Manuscript Preparation: A. Writing of the first draft, B. Review and Critique; AYY: 1A, 1B, 1C, 2A, 2C, 3A, 3B. ER: 1A, 1C, 2A, 2B, 2C, 3B. JJ: 1A, 1B, 1C, 2A, 2C, 3B.

Corresponding author

Correspondence to Joseph Jankovic.

Conflicts of interest

The authors declare that there are no conflicts of interest relevant to this work. The authors have no relevant financial or non-financial interests to disclose.

Ethical compliance statement

The institutional review board (IRB) of Baylor College of Medicine, Houston, TX, USA, and Charles University, Prague, Czech Republic approved this study. Given the retrospective nature of the chart review, compliance with IRB policies obviated the requirement for written informed consent from the patients. All individuals who were video recorded at Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, USA signed a written clinic consent form prior to the recording. We confirm that we have read the Journal’s position on issues involved in ethical publication and affirm that this work is consistent with those guidelines.

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