Some patients with Parkinson's disease develop postural instability and gait difficulty (PIGD). The presence of postural instability and gait difficulty has been correlated with disease progression.
Major motor subtypes for Parkinson's disease:
(1) tremor dominant
(2) postural instability and gait difficulty dominant
Significance of PIGD:
(1) PIGD tends to be seen in advanced stages of Parkinson's disease.
(2) Early onset and/or severe PIGD are associated with rapid disease progression ("malignant").
(3) Patients with PIGD tend to have greater severity of nondopaminergic symptoms (cognitive dysfunction, autonomic dysfunction, depression, excessive daytime sleepiness, psychosis).
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