Extrapyramidal Syndromes - Causes, Symptoms and Treatment .MF .
Extrapyramidal disorders - a change in muscle tone, disturbance of locomotor activity, the appearance of hyperkinesis (twitches) or hypokinesia (immobility), and combinations thereof.
appear such symptoms in lesions of specific brain structures - the extrapyramidal system.This - the thalamus, basal ganglia, podbugornaya area inside the capsule.
In the development of extrapyramidal disorders is a violation of neurotransmitter metabolism - an imbalance between dopaminergic and cholinergic neurotransmitters, as well as relationships with the pyramidal system.The result discoordination movements.
extrapyramidal system ensures the regulation of posture, tone, change in muscle tone provides a willingness to move, smooth, speed, precision movements, friendly movement (eg, walking waving hands and feet movement).Through connections with the cerebral cortex, the hypothalamus and the limbic system extrapyramidal education participate in providing higher nervous activity, especially in the emotional sphere.
Extrapyramidal hypokinesia appear in lesions of the frontal lobes, the substantia nigra and reticular formation.Hyperkinesia striatal lesions occur when the nucleus of the thalamus, red nucleus, cerebellar-thalamic path.
extrapyramidal hyperkinesis - is excessive, involuntary, violent movement.
athetosis - manifested in the fingers, - slow, writhing, worm-like movements.Athetosis facial muscles manifest distortion of the mouth, twitching lips and tongue.Muscle tension is replaced by a decrease in tone and relaxation.Most occur in lesions of the caudate nucleus, globus pallidus abuse linkages and red nucleus.such violations may be due to birth injury, epidemic encephalitis, traumatic - brain injury, atherosclerosis, syphilis.
Chorea - a variety of rapid violent movement muscles of the trunk and limbs, neck and face, not rhythmic or consequential, arising in the background of reduced muscle tone.
torsion spasm - it dystonia of the trunk muscles.The disease can begin at any age.Hyperkinesis appear when walking - bend, shtoporopodobnye, rotational muscles of the neck and trunk.The first symptoms may begin with the neck muscles - torsional torticollis - violent side head movements.Torsion torticollis can be isolated pathology, without the involvement of other muscle groups.It may manifest as a disease "writer's cramp".When writing your fingers come into a state of hyper, tense and small movements are impossible, you can not let go brush.At certain points during muscle spasm patients as if frozen in the same position.Develops torsion spasm in inflammatory diseases - encephalitis, hereditary degenerative diseases.Applied for the treatment of muscle relaxants - Mydocalmum, baclofen, sedatives, vitamins B.
Tick -. Repetitive jerking of single muscles, often the face, eyelids, neck - jerking neck, throwing the head back, twitchingshoulder, winking, namorschivanie forehead - the same type of motion.Most often seen in nervous tension, stress.In the treatment of used sedatives and muscle relaxants - Valerian tablets, dormiplant, novopassit, Sedavit, afobazol, pantokaltsin, Mydocalmum, vitamin B6, reflexology.
myoclonus - quick, short jerks, lightning in the individual muscle or muscle group.There are at Kozhevnikov epilepsy, encephalitis.
hemiballismus - unilateral toss out the sweeping movements of the extremities (usually hands).Occurs when the body defeat luisova tuberkulomah, syphiloma, metastatic tumors, with encephalitis, vascular diseases.
giperkinezy All these can be isolated, can be combined.For example, choreoathetosis.
giperkinez aggravated by excitement, physical exertion and disappear during sleep.
Tremor - shake - rhythmic fast movements of small amplitude.Postural tremor occurs when you hold poses, such as the extended hand forward.Kinetic tremor occurs during movement.Intention tremor occurs when approaching the target, for example, when trying to get a finger in the nose - the closer to the nose - the stronger tremor.Resting tremors occur at rest and during movement decreases, which is characteristic of Parkinson's disease.
There are tremors primary - essential and secondary, as a manifestation of physical illness (liver, kidney, thyroid) and nervous system (degenerative diseases - Konovalova - Wilson's, Parkinson's, cerebellar degeneration, traumatic brain injury, tumor) or intoxication (alcohol, manganesemercury, a number of drugs - psychotropic, bronchodilators, drugs).When any tremor need to see a neurologist and undergo individual designated inspection.
Face gemispazm - the tonic reduction of muscles of half the face, neck and tongue, with closed eyes, mouth overtighten.
With the defeat of the extrapyramidal system is possible violent laughing, crying, different faces.
When any cramps, spasms, changes in muscle tone, the violation of precision and focus movements need to see a neurologist.The neurologist will examine you, will conduct a series of tests to check the function of the extrapyramidal system and the general neurological examination.To determine the pathological process will need blood tests, inspection of an ophthalmologist, computer and (or) magnetic resonance imaging.Independently understand this disease the patient can not.The differential diagnosis is carried out with encephalitis, brain vascular and infectious diseases (tuberculosis, syphilis ...).It requires exclusion of cancer pathology.
Huntington's chorea (St. Vitus dance) - heavy progressive hereditary disease.Starting at 30-40 years advent choreiform hyperkinesis and progressive dementia (dementia).Hyperkinesia slow, sweeping, no muscle hypotonia.Degenerative process affects the shell, the caudate nucleus, the cells of the frontal lobe of the brain.The tyrosine content of the blood is increased, which has a major role in the biochemistry of extrapyramidal system.
on EEG can detect diffuse brain aktivnoti change, the lack of alpha rhythm, the emergence of slow waves.When CT - atrophic processes.In the treatment of used abiksu (memantine), dopamine antagonists - triftazin, dopegit, reserpine, vitamin B, neuroprotective agents.
disease is severe, the diagnosis plays the role of family history.With the progression leads to disability.Patients seen by a neurologist, a psychiatrist in need of assistance.
hyperkinesis with Huntington's disease and the area lesions in the brain
gepatotserebralnoy dystrophy (Konovalova - Wilson) - a hereditary disease disorders of copper metabolism, which interferes with protein ceruloplasmin synthesis and copper is deposited in the tissues - liver, brain,cornea, not excreted.It may begin at any age, but the sooner, the harder and faster for death.There are abdominal shape, rigidity - aritmogiperkineticheskuyu, shaking, tremor - rigidity, extrapyramidal - cortical.More common tremor and tremor - rigid form.Beginning at the age of 15-20 with sweeping hyperkineses - hands make "flying wings", muscular rigidity.We describe the atypical forms of the beginning of a writer's cramp or torsional dystonia.Condition progressively worsens, added mental disorders - emotional lability, disinhibition - dementia.Possible seizures.The course of the disease is slowly progressive without remissions.In the early stages must be distinguished from multiple sclerosis, brain tumor, encephalitis, Huntington's disease, early onset of Parkinson's.The diagnosis is important survey of the oculist, which detects when a slit lamp examination, brownish - green ring (Kayser - Fleischer), blood levels of copper and ceruloplasmin reduced in urine - increased copper content.It affects the liver - cirrhosis, kidney.Specific therapy is for life - D-penicillamine, kuprenil.Use rates unitiol, B vitamins, neuroprotective, anti-oxidants, anti-epileptic drugs, if necessary.Patients are observed for life by a neurologist, a gastroenterologist.
athetosis at illness Konovalova - Wilson
Parkinsonism - a chronic, progressive neurodegenerative disorder for which there are specific movement disorders - akinesia, tremor, muscle rigidity, autonomic imbalance, cognitive (mental) disorders, emotional poverty.There may be as Parkinson's disease Parkinson's disease and may develop secondary to infectious diseases, toxic, traumatic, vascular lesions of the nervous system - the secondary symptomatic parkinsonism.Read more in the article Parkinson's disease, parkinsonism.
When vascular disease - atherosclerosis, hypertension develops chronic cerebrovascular disease - encephalopathy, one of the symptoms which can be extrapyramidal insufficiency, and in severe cases, parkinsonian syndrome.In the treatment focuses on the underlying disease, use hypotensive, anti-sclerotic, cardiovascular drugs, sedatives, neuroprotective, health resort treatment.Treatment is appointed by the doctor - a neurologist.
Eonsultatsiya doctor of extrapyramidal syndromes:
Question: How is essential tremor?
Answer: Delete the neuro - emotional overload, limit the intake of coffee and turn to the neurologist.Use medicines - vitamin B6 in large doses, pantokaltsin, propranolol, gabapentin formulations (gabantin, gatonin, gabagama) afobazol, Noofen, adaptol, psychotherapy, reflexology.
neurologist Kobzev SV