Early axial involvement in progressive supranuclear palsy with progressive gait freezing: A rare case report
Esra Demir Ünal1
, İrem Ceyda Bildik2, Zehra Yavuz2, Selim Selçuk Çomoğlu3
1Department of Neurology, Ankara Yıldırım Beyazıt University Medical Faculty, Ankara, Türkiye
2Department of Neurology, Ankara Etlik City Hospital, Ankara, Türkiye
3Department of Neurology, University of Health Sciences Gülhane Faculty of Medicine, Ankara, Türkiye
Keywords: Axial rigidity, freezing of gait, interpeduncular fossa enlargement, mesencephalic contour flattening, progressive supranuclear palsy.
Abstract
Progressive supranuclear palsy with progressive gait freezing (PSP-PGF) phenotype represents a unique presentation pattern emerging with selective involvement of axial locomotor networks in the early stages, where clinical findings may manifest before structural imaging biomarkers become evident. This case report presents a 68-year-old male patient unresponsive to standard levodopa therapy, characterized by a two-year insidious and progressive course of recurrent and complete blockages in gait initiation, a tendency toward retropulsion, and marked axial rigidity, while limb parkinsonism remained minimal and tremor was absent. This case emphasizes the importance of differential diagnosis in PSP cases presenting with early-onset predominant freezing of gait.
Cite this article as: Demir Ünal E, Bildik İC, Yavuz Z, Çomoğlu SS. Early axial involvement in progressive supranuclear palsy with progressive gait freezing: A rare case report. Parkinson Hast Harek Boz Derg 2026;29(1):22-25. doi: 10.5606/phhb.dergisi.2026.60.