Rademaker and Garcin syndrome associated with pallidal calcifications]

We report gait abnormalities with exaggerated support against gravity in a 76 year-old woman. This exaggeration, and its demonstration by ankle dorsiflexion in supine position, was first described by Rademaker and Garcin (1933) as probably resulting from cerebellar and brainstem lesions. In the present case, quantitative analysis of locomotion showed a strong reduction in both stride duration and stride length. There was an increased variability between two consecutive locomotor cycles and a large increase in both stance duration and relative double-support duration. Electromyography clearly showed leg hypertension following ankle dorsiflexion, contrasting with normal leg mobility in the supine patient. This suggested that reflexive antigravity support abnormalities could explain this pattern of locomotor disabilities, differentiating them from other kinds of "marche à petits pas". The present case was associated with bilateral pallidal calcifications, suggesting an involvement of the basal ganglia in support reaction against gravity and in control of adequate postural muscle tone necessary for locomotion.