Ask the Experts - Senile Gait Disorder
At present, what is the best pharmacologic treatment for "vascular parkinsonism," in particular, the lower body form?

Parkinsonian features such as slowness, stiffness, and difficulty with gait can occur on vascular basis. Lower body parkinsonism is a term that has been used to describe patients, usually elderly, who have a parkinsonian gait with shuffling and freezing but no upper extremity signs. The person's gait may be wide-based and also have apraxic features. This entity has also been referred to senile gait or gait abnormality of the elderly. Often, however, there are no other signs of neurologic dysfunction and dementia is absent. The pathophysiologic basis of this disease is unclear. Sometimes periventricular white matter changes are seen on MRI scan of the head, as occurs in patients who are chronic hypertensives.

Currently, there is no treatment for this condition. Anti-parkinsonian medications are of no benefit. Physical therapy may provide some benefit.