The origin of gait disturbance in normal pressure hydrocephalus (NPH) is poorly understood. We assessed the frequency of frontal and sub-cortical hypokinetic gait clinical features and changes in gait variables after lumbar puncture (LP), in 15 patients with idiopathic NPH. Hypokinesia and disequilibrium were the main features, suggesting dysfunction of the basal ganglia (BG) and the frontal lobe (FL), respectively. Disequilibrium responded worse to LP and frontal signs were more frequent in patients that did not improve after LP. This could be related to earlier disturbance of frontal gait control.