A soldier was found with a peculiar walking tic. He would rest a good deal longer on the left leg than on the right. He would make a sudden movement of the right leg forward, as if on a spring. At the same time, the man’s head would give a violent movement to the right just as the right leg was receiving the weight of the body. The idea of this movement seemed to be that the center of gravity would be shifted and the work of the right leg would be relieved. This peculiar walk was naturally very slow. If the walk was slowed down, it became quite normal. There was no pain at the basis of this walk. If the man hopped, he hopped no more painfully on the right leg, nor with greater difficulty, than upon the left.
This man was guilty of desertion in the face of the enemy, and of desertion in the interior in time of war. He said he could not walk well and that he needed to take care of himself at his mother’s house, as he was not considered sick in his regiment. He had been wounded with two bullets, September 28, 1914, which struck him on the internal aspects of the knees. He was treated in hospital from October to the end of November, 1914; was held at the dépôt of his regiment from December to August, 1915. He was then put in hospital a month, and returned to his dépôt for three more months. He was examined by three physicians in August, 1915, and the commission decided that he was fit for service, and a simulator.
Thorough examination, including electrical and X-ray examinations, showed no lesion. Chavigny observed the patient for a long time, from the 21st of November, 1916, to January 5, 1917. Shells dropped near the hospital, December 2, and, following orders, the patients were taken into a vaulted cellar, and they ran thither very rapidly; but this patient could not hurry. He walked slowly, with the same tic. Surely the tic would be rather a difficult one to imagine, and a somewhat more probable set of symptoms would ordinarily be chosen. The man has not the unstable nature of the ordinary victim of tic. On the contrary, he has rather the invincible obstinacy of a hysterotraumatic. On being shown that he could walk properly without these “para” movements, he would reply, “I can’t do anything else,” and he shook his head upon being told that he could be cured.
Reëducation of his anesthetic areas (there was a zone of diminution in sensibility to pin-prick in the knee region, and a complete anesthesia of the sole of the foot, with abolition of the plantar reflex), reëducation by appropriate gymnastics, and mental reëducation, might be attempted in a special neurological hospital.
Re disorders of gait, Laignel-Lavastine and Courbon divide functional gait disorders into three groups: (a) A group called dynamogenic; (b) an inhibitory group; and (c) a group showing both forms of disorder.
Roussy and Lhermitte have attempted to divide the gait disorders into two groups: (a) A group termed by them basophobic, in which there is a marked psychogenic and emotional basis; and (b) a dysbasic group, the basis of which is suggestion rather than emotion. Following is a skeleton of their classification:
1. Astasia-abasia and dysbasia group.
- Astasia-abasia.
- Pseudo tabetic dysbasia.
- Pseudo polyneuritic dysbasia.
- Tight-rope walker’s gait.
- Scrubber’s gait.
- Choreiform dysbasia.
- Knock-kneed gait.
- Walking as if on sticky surface.
- Bather’s gait.
2. Stasobasophobia group.
3. Habit limping.