Gait Apraxia and Hakim's Disease: A Historical Review

In 1965, Prof. Salomon Hakim described, for the first time, a condition characterized by normal pressure hydrocephalus and gait alterations. During the following decades, definitions such as Frontal Gait, Bruns' Ataxia and Gait Apraxia have been frequently used in pertinent literature in the attempt to best define this peculiar motor disturbance. More recently, gait analysis has further shed light on the typical spatiotemporal gait alterations that characterize this neurological condition, but a clear and shared definition of this motor condition is still lacking. In this historical review, we described the origins of the terms Gait Apraxia, Frontal Gait and Bruns' Ataxia, starting with the first works of Carl Maria Finkelburg, Fritsch and Hitzig and Steinthal during the second half of the 19th century and ending with Hakim's studies and his formal definition of idiopathic normal pressure hydrocephalus (iNPH). In the second part of the review, we analyze how and why these definitions of gait have been associated with Hakim's disease in the literature from 1965 to the present day. The definition of Gait and Postural Transition Apraxia is then proposed, but fundamental questions about the nature and mechanisms underlying this condition remain unanswered.

Automated summary

In 1965, Prof. Salomon Hakim first described a condition characterized by normal pressure hydrocephalus and gait alterations. Various definitions have been used over the years to define this motor disturbance, but a clear and shared definition is still lacking. Gait analysis has provided insights into the gait alterations, but fundamental questions about this condition remain unanswered.