Presentation
Abstract This paper describes a diabetic dialysis patient presenting two episodes of symmetric basal ganglia lesions occurring 18 months apart, and discusses the MR imaging findings and the pathogenesis of this condition. © The Author(s) 2015 Reprints [ncbi.nlm.nih.gov]
A 67-year-old Indian man presented with two days history of acute onset generalized dyskinesia associated with mild confusional state. [annalsofian.org]
Similarly, the present report details a patient with nonketotic hyperglycemia and a hyperdense basal ganglion lesion with an unusual clinical presentation. [ceemjournal.org]
Case 2 A 46-year-old male patient presented with sudden onset of slurred speech, slow gait and loss of balance. His medical history revealed insulin resistance and ESRD. [jneuro.com]
Neurologic
- Tremor
[…] restricted to extrapyramidal tract, patients have NO paresis or neuropsychological impairments Characteristic features of basal ganglia (i.e., extrapyramidal) injury involve the following involuntary movement disorders: Parkinsonism – combination of resting tremor [brainaacn.org]
The tremor has been erroneously considered a tremor at rest, but actually it is a tremor of postural or resting muscle tension. [dartmouth.edu]
During follow up the tremor and gait imbalance resolved within 7 days and recurrent episode of hypoglycemia was not observed. [jneuro.com]
[…] thalamus and cortex rigidity, increased tone, slow reduced movements, bradykinesia/hypokinesia, stooped posture, resting tremor are all symptoms of.... [memorize.com]
- Chorea
In 39 patients, chorea had ameliorated completely. The remaining 14 cases showed some improvement during the follow-up period. The chorea recurred in seven patients. CONCLUSION: C-H-BG is a benign disorder affecting the elderly. [ncbi.nlm.nih.gov]
Hyperglycemia associated unilateral predominant chorea could demonstrate with symmetrical T1–hyperintense lesions in basal ganglia on brain MRI. [mdsabstracts.org]
Types of Hyperkinesia Chorea: Huntington’s chorea and Sydenham chorea. Wilson’s disease. Athetosis. Dystonia. Ballismus/Hemiballismus. Tardive dyskinesia. [drnajeeblectures.com]
The model for choreiform disorders is Huntington's chorea. [dartmouth.edu]
[…] injury involve the following involuntary movement disorders: Parkinsonism – combination of resting tremor, rigidity, bradykinesia/akinesia, and postural abnormalities Athetosis – slow continuous, writhing movements of the fingers, hands, face, and throat Chorea [brainaacn.org]
- Resting Tremor
tremor, rigidity, bradykinesia/akinesia, and postural abnormalities Athetosis – slow continuous, writhing movements of the fingers, hands, face, and throat Chorea – intermittent jerking of limbs and trunk Hemiballismus – intermittent flinging of the [brainaacn.org]
[…] thalamus and cortex rigidity, increased tone, slow reduced movements, bradykinesia/hypokinesia, stooped posture, resting tremor are all symptoms of.... [memorize.com]
Symptoms The disease is diagnosed by observing a set of characteristic symptoms that affect motor control: resting tremor, bradykinesia, and hypertonia. Resting tremor is an oscillating movement that occurs when the patient is trying to be still. [courses.washington.edu]
tremor in jaw, lip, tongue Rigidity - cogwheel rigidity Bradykinesia - freezing Hypokinesia/akinesia - reduced frequency of swallow Hypokinetic Dysarthria: Other Neuromuscular Deficits Resting tremors of head, limbs, pill-rolling Festinating gait Decrease [ucs.louisiana.edu]
Low-amplitude bilateral upper limb resting tremor, bradykinesia and ataxic gait was present. Laboratory investigations indicated raised blood urea, 76 mg/dL (17-43) and serum creatinine, 8.3 mg/L (0.5-1.1) levels. [jneuro.com]
- Dysarthria
CODI 555 Motor Speech Disorders Lecture 4: Basal Ganglia Disorders: Hypokinetic/Hyperkinetic Dysarthria Basal Ganglia Control Circuits Consist of several intertwining loops among the basal ganglia nuclei & thalamic nuclei Striatum (caudate & putamen) [ucs.louisiana.edu]
Neurological examination revealed dysarthria, dysphonia and quadriparesis. Low-amplitude bilateral upper limb resting tremor, bradykinesia and ataxic gait was present. [jneuro.com]
The pseudobulbar signs (948) include dysphagia with hyperactive gag reflex, emotional incontinence, and a severe dysarthria that combines pseudobulbar, parkinsonian and cerebellar features (950,951). [neuroophthalmology.ca]
A single case has been reported who had both the movement disorders co-existing. [4] Other less common neurological features have included mild confusional state, gait disturbances, dysarthria, and dysphagia. [annalsofian.org]
Most of these patients have early gait difficulty and there is often a significant dysarthria early in the course. Voluntary vertical gaze is also affected very early in the course. [dartmouth.edu]
- Abnormal Gait
Truncal dyskinesia, right side predominant limbs chorea, cervical dystonia and abnormal gait gradually developed. Laboratory data showed hyperglycemia (sugar: 436 mg/dl). [mdsabstracts.org]
•Acute episode in otherwise healthy person -paresthesia on face or one extremity (early signs) -vertigo/nystagmus /altered vision/diplopia -abnormal gait, fatigue, altered speech -Lhermitte sign (nerve traction -C/S flexion) -bladder/ sexual dysfunction [quizlet.com]
Treatment
Li et al. reported that there is no specific treatment for this condition thus we did not prescribed any treatment in addition to insulin injections and hemodialysis [ 10 ]. [jneuro.com]
Each triennial meeting of IBAGS brings together basic research scientists from all disciplines as well as clinicians who are actively involved in the treatment of basal ganglia disorders, to discuss the most recent advances in the field and to generate [books.google.com]
Presently, treatment consists of calcium supplementation and the use of vitamin D analogs, but PTH replacement is under investigation. Treatment is important to prevent progression of BGC. Competing interests None declared. References 1. [bcmj.org]
Lancet Oncology 5, 1-8, 2009 4) Serizawa T, Iuchi T, Ono J et al: Gamma knife treatment for multiple metastatic brain tumors compared with whole-brain radiation therapy. [chiba-neurosurgery.jp]
There is no effective treatment other than palliation. [dartmouth.edu]
Prognosis
Prognosis of Basal Ganglia Stroke Approximately 33% of all stroke cases are deadly. [healthfixit.com]
Secondary progressive disease - gradual neurological deterioration with or without relapses - Primary progressive disease - nearly continuous neurological deterioration from onset of symptoms -worst prognosis - Treatment - acute episodes with corticosteroids [quizlet.com]
[…] symmetric signal-intensity alterations in the mammillary bodies, medial thalami, tectal plate, and periaqueductal area. 1 – 4 Selective involvement of the putamen has been reported only in the pediatric population and is considered an indicator of poor prognosis [ajnr.org]
Although usually symptoms tend to spontaneously regress, it is believed that it might indicate poor prognosis and advanced disease [ 2, 8 ]. [jneuro.com]
The extent of white matter involvement, sometimes best depicted at diffusion weighted imaging, is a factor of poor prognosis [ 1 ]. [em-consulte.com]
Etiology
[…] stop Results from lack of dopamine in basal ganglia circuits Hyperkinesia - involuntary movements Excessive, unpredictable increases in muscle tone and movement Result of excessive activity in dopaminergic nerve fibers Hypokinetic Dysarthria: Common Etiologies [ucs.louisiana.edu]
As such, diagnosis of the underlying etiology may be difficult to achieve at imaging. [em-consulte.com]
Basal ganglion lesions in Psychiatric Diseases• ADHD : – Although the etiology of ADHD yet has to be determined, there is a growing consensus that the condition involves functional and anatomical dysfunction in the brains frontal cortex and basal ganglia [slideshare.net]
This has led to speculation concerning the etiology of parkinsonism and to clinical trials of both entities to determine a possible prophylactic effect in idiopathic parkinsonism. [dartmouth.edu]
Epidemiology
Pagina 15 - Schiffer RB, Babigian HM: Behavioral disorders in multiple sclerosis, temporal lobe epilepsy, and amyotrophic lateral sclerosis: an epidemiologic study. [books.google.it]
Pathophysiology
Cools Springer Science & Business Media, ٠٣/٠٥/٢٠١٠ - 608 من الصفحات The aim of the International Basal Ganglia Society (IBAGS) is to further our understanding of normal basal ganglia function and the pathophysiology of disorders of the basal ganglia [books.google.com]
This research topic aims to bring together the most recent advances related to the pathophysiology of the basal ganglia and movement disorders. [frontiersin.org]
Wichmann T and DeLong MR (1996) Functional and pathophysiological models of the BG. Current Opinion in Neurobiology 6: 751–758. [els.net]
Its pathophysiology remains largely unknown. Uremic toxins, metabolic acidosis and diabetic microangiopathy are among the factors believed to contribute to its pathogenesis. [jneuro.com]
• Dorsal tier = low levels of dopamine = input from limbic-related structures = the pathophysiology of SCHIZOPHRENIA.• The VENTRAL TIER comprises 1. The dopamine neurons that are densely packed in the substantia nigra 2. [slideshare.net]
Prevention
Prevention of Stroke Any forms of CVA are dangerous to face. The best way to never experience stroke is prevention. In order to do that, risk factors (as enumerated in the earlier section of this article) to stroke should be eliminated. [healthfixit.com]
Treatment is important to prevent progression of BGC. Competing interests None declared. References 1. Rumboldt Z, Castillo M, Huang B, et al. (eds). Brain imaging with MRI and CT: An image pattern approach. [bcmj.org]
They are unable to make the appropriate kinetic-postural adjustment necessary to prevent them from falling. [dartmouth.edu]
Or if you have migraines, you can take medicine to both prevent and treat them. If you are anxious or depressed, see your doctor. There are medicines to help with mood issues. [webmd.com]
For motor skills, the basal ganglia are critical in preventing muscular overreactivity. In MS, the basal ganglia don’t deliver neurochemical signals with fluidity. [multiplesclerosisnewstoday.com]