The clinical presentation of Wilson disease (WD) is highly variable. We report an unusual presentation of Wilson's disease with de novo seizures and acute extrapyramidal features without hepatic manifestations. [neurologyindia.com]

It remains possible that the presentation of an extrapyramidal syndrome merely represents a chance association of a rare disorder with a more common one. [jnnp.bmj.com]

Dystonia is considered present when repeated, often asynchronous spasms of muscles are present. Most dystonias are idiopathic and the focal form of dystonia occurs 10 times more often than does the generalized systemic form. [pocketdentistry.com]

The condition can present with tremor or with rigidity. Rarely, it can primarily present with balance issues in the absence of other symptoms. These cases are particularly difficult to diagnose. [dartmouth.edu]

Presentation on theme: "Extrapyramidal disorder and movement disorder"— Presentation transcript: 1 Extrapyramidal disorder and movement disorder 2 the main cause behind the movement disorders is dysfunction of deep seated sub cortical gray matter called [slideplayer.com]

• Falling

  Normally, people will regain their balance by taking 2-3 steps backwards and will not fall. Parkinsonian patients often need to take more steps than this, or will fall back. [fastbleep.com]

  To make squares disappear and save space for other squares you have to assemble English words (left, right, up, down) from the falling squares. boggle Boggle gives you 3 minutes to find as many words (3 letters or more) as you can in a grid of 16 letters [dictionary.sensagent.com]

  They are unable to make the appropriate kinetic-postural adjustment necessary to prevent them from falling. [dartmouth.edu]

  One year later she had developed poor balance, frequent falls, tremor predominantly affecting her right hand, urinary urgency, and impaired concentration and episodic memory. [jnnp.bmj.com]

  Agents/circumstances to avoid: Persons with dystonia should avoid situations in which the risk of falling is increased. [ncbi.nlm.nih.gov]

• Motor Restlessness

  Benzodiazepines – Benzodiazepines such as valium may also be given to stabilize the nerve impulse transmission to reduce motor restlessness. [healthfoxx.com]

  These symptoms include dystonia (continuous spasms and muscle contractions), akathisia (motor restlessness), parkinsonism (characteristic symptoms such as rigidity), bradykinesia (slowness of movement), tremor, and tardive dyskinesia (irregular, jerky [en.wikipedia.org]

  Akathisia reactions occur as a subjective experience of motor restlessness. Patients may complain of an inability to sit or stand still, or a compulsion to pace or cross and uncross their legs. [pocketdentistry.com]

  11 Perhaps in this and earlier studies the subjective observation of akathisias was not adequately differentiated from the motor restlessness/agitation sometimes seen with SSRIs. [ptcommunity.com]

• Urinary Retention

  retention, impaired sweating, tachycardia Surgery, Implantations and Infusions : Surgery, Implantations and Infusions Thalamotomy Pallidotomy Deep brain stimulation (DBS) Intra-striatal human retinal cells implant (Spheramine) Growth factor infusion [authorstream.com]

  retention, and tachycardia More common in low- potency FGAs Mild in high- potency FGAs Uncommon in most agents Clozapine, olanzapine, and quetiapine have the highest incidence of anticholinergic effects. [amboss.com]

  retention  Hallucination, confusion C/I: in glaucoma, SPH, Pyloric stenosis 59. [slideshare.net]

  Treatment options include decreasing or dividing doses or switching to a medication with a lesser antiadrenergic effect. 6 Anticholinergic Effects Anticholinergic effects include constipation, urinary retention, dry mouth, blurred vision and, at times [aafp.org]

  Anticholinergic and Antiadrenergic Effects The low-potency FGAs or the high-potency FGAs given with antiparkinsonian drugs can produce a variety of peripheral nervous system side effects like dry mouth, constipation, urinary retention, and blurred vision [primarypsychiatry.com]

• Extrapyramidal Symptoms

  Extrapyramidal Disorder Symptoms and Signs The extrapyramidal symptoms are a collection of side-effects that commonly occur with certain use of medications. [healthfoxx.com]

  Extrapyramidal symptoms caused by these agents are indistinguishable from neuroleptic-induced extrapyramidal symptoms. [ncbi.nlm.nih.gov]

  Extrapyramidal symptoms ( EPS ), also known as extrapyramidal side effects ( EPSE ), are drug-induced movement disorders that include acute and tardive symptoms. [en.wikipedia.org]

  What Are Extrapyramidal Symptoms? Extrapyramidal symptoms (also known as EPS) are a set of side effects that are common with antipsychotic medications, as well as with a few other types of medications. [schizophrenia.emedtv.com]

  The Extrapyramidal Symptoms Rating Scale. [eprovide.mapi-trust.org]

• Bradykinesia

  Bradykinesia and rigidity are additive in hindering movement and are usually present together. Bradykinesia is, however, not dependent on or necessarily proportional to rigidity, and vice versa. [dartmouth.edu]

  Since this system regulates posture and skeletal muscle tone, a result is the characteristic bradykinesia of Parkinson's. [en.wikipedia.org]

  Parkinson’s DiseaseClinical features : Parkinson’s DiseaseClinical features Hypo-bradykinesia: Main disabling feature Poverty of movements Slowness in initiation and execution FACE EYES SPEECH WALKING POSTURAL REFLEX. [authorstream.com]

  It includes muscle stiffness, pill rolling tremor and reduced movements (Bradykinesia). It usually occurs months after start of antipsychotic drug treatment. It is treated with anti-cholinergic drugs mentioned such as Benzhexol. [mentalhealthdoc.blogspot.com]

  The symptoms of parkinsonism include: Bradykinesia Muscle rigidity and/or cogwheeling Masked facies (may look similar to flat affect) Hand tremor Decreased arm swing Elderly women are at the highest risk for this condition. [learn.pharmacy.unc.edu]

• Excitement

  Lesions above the pontine reticular formation but below the midbrain cause decerebrate rigidity because of the removal of central inhibition from the pontine reticular formation, resulting in excitation of α- and γ-motoneurons and rigid posture. [forums.studentdoctor.net]

   Hypotonia  Pronator sign  Milkmaid’s grip  Spooning sign  Pendular knee jerk “hung up reflex”  Lizard tongue Increased by excitement, diminished by sleep Sydenham chorea (Saint vitus dance) more common in female and childhood (5-15yrs), associated [slideshare.net]

  Therefore, when the tonic activity of dopamine is lost, the motor and premotor cortex are less excitable and the patient is less mobile, with slower responses and less spontaneous movement. [dartmouth.edu]

• Cerebellar Disease

  Tremor:------ -Enhanced PSL tremor:------ -cerebellar disease----- -Wilson’s disease----- -Benign essential tremor: autosmal D., or idiopathic ,50 % positive family history ,it can affect head and neck INTENTION TREMOR : seen in cerebellar disease ,Wilson [slideplayer.com]

  […] tremor,  Intention Tremor: Most prominent during voluntary movement toward a target eg: cerebellar disease 61.  Etiology: Parkinsonism Essential tremor Physiologic tremor Alcohol Anxiety Thyrotoxicosis Cerebellar disease Wilson disease Red [slideshare.net]

• Motor Disturbances

  DISTURBANCE PYRAMIDAL TRACT FATIGUE STUDIES PROCYCLIDINE FAMILIAL FACTOR ATYPICAL ANTIPSYCHOTICS Cite this page: N., Pam M.S., "EXTRAPYRAMIDAL EFFECTS," in PsychologyDictionary.org, May 11, 2013, https://psychologydictionary.org/extrapyramidal-effects [psychologydictionary.org]

  [Rather radical therapies in a patient with motor disturbances]. Pharm Weekbl 1992;127:869–72. Google Scholar 16. Fahn S. An open trial of high dosage antioxidants in early Parkinson's disease. Am J Clin Nutr 1991;53:380S-2S. [link.springer.com]

Treatments include: Medications Medications are the primary treatment of extrapyramidal symptoms. [healthfoxx.com]

Vitamin E in the treatment of tardive dyskinesia. Am J Psychiatry 1990;147:505–6. PubMed Google Scholar 13. Egan MF, Hyde TM, Alberts GW, Elkashef A, Alexander RC, Reeve A, et al. Treatment of tardive dyskinesia with vitamin E. [link.springer.com]

Treatment varies by disorder. Medicine can cure some disorders. Others get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms and relieve pain. [icdlist.com]

TREATMENT Treatment of movement side effects that appear early during treatment (EPS) is generally accomplished by slowly withdrawing the drug or lowering the dose. [medicalnewstoday.com]

It is treated usually experts and prognosis is usually poor. Following video shows tardive dyskinesia. First posted in [mentalhealthdoc.blogspot.com]

Conclusions The expected improvement in EPS profiles for participants randomised to second-generation drugs was not found; the prognosis over 1 year of those in the first-generation arm was no worse in these terms. [bjp.rcpsych.org]

[…] can add a significant burden, reducing patients’ quality of life and contributing to noncompliance. 1 Effective management of these unwanted effects of antipsychotics has the potential to improve patients’ compliance, quality of life, and possibly the prognosis [primarypsychiatry.com]

Etiology Woodhouse-Sakati syndrome is associated with mutations in the DCAF17 gene (2q31.1), encoding a nucleolar protein of unknown function. Genetic counseling The disease is transmitted in an autosomal recessive manner. [orpha.net]

[…] syndrome Neurology A condition characterized by a range of findings–eg, rigidity, tremors, drooling, shuffling gait–parkinsonism, akathisia–restlessness, dystonia–odd involuntary postures, akinesia–motor inactivity, and other neurologic disturbances Etiology [medical-dictionary.thefreedictionary.com]

The role of environmental toxins in the etiology of Parkinson's disease. Trends Neurosci 1989;12:49–54. PubMed CrossRef Google Scholar 18. Fahn S. [link.springer.com]

This volume discusses the extensive clinical boundaries of acute dystonias, drug-induced parkinsonism, akathisia and tardive dyskinesia, providing demographic and epidemiological context while illustrating how prescribing choices impact powerfully on [books.google.com]

Summary Epidemiology Approximately 30 patients from consanguineous Middle Eastern families, together with one Caucasian woman and three sibs from an Indian family, have been reported so far. Clinical description The onset is usually in adolescence. [orpha.net]

Basic description Originally developed in 1979 for epidemiological studies of tardive dyskinesia in schizophrenic outpatients on long-term classical anti-D2 antipsychotic medications Authors Chouinard G Copyright Extrapyramidal symptom rating scale (ESRS [eprovide.mapi-trust.org]

Tardive dyskinesia: Epidemiology. Journal of the Neurological Sciences, Vol. 389, Issue., p. 17. [bjp.rcpsych.org]

No adequate epidemiologic data exist regarding whether any particular psychiatric diagnosis constitutes a risk factor for the development of tardive reactions to medications; however, the duration of exposure to antipsychotics that is required to cause [pocketdentistry.com]

Akathisia Not a lot is known about the pathophysiology of akathisia. It is described as a “feeling of inner restlessness.” [learn.pharmacy.unc.edu]

However, the acute features in our case with normal liver functions are difficult to explain at present on the basis of existing literature and warrant further studies regarding pathophysiology of brain damage in WD. » References 1. [neurologyindia.com]

MPTP a neurotoxin relevant to the pathophysiology of Parkinson's disease. Neurology 1986;36:250–8. PubMed CrossRef Google Scholar 29. Koller W, Vetere-Overfield B, Gray C, Alexander C, Chin T, Dolezal J, et al. [link.springer.com]

The pathophysiology of bruxism is unknown. The most cogent theory describes bruxism as a neuromotor dysregulation disorder. This theory proposes that bruxism occurs because of the failure to inhibit jaw motor activity during a sleep state arousal. [pocketdentistry.com]

Pathophysiology : Inhibition of the nigrostriatal dopaminergic pathways results in EPS. [amboss.com]

For tardive dystonia, prevention is the most important treatment since few pharmacologic treatments have proven efficacy. Prevention also is the key to managing akathisia. [the-hospitalist.org]

Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎ [books.google.es]

Standardized titration to avoid excessive dosage escalation and the use of atypical antipsychotics are successful measures of prevention. [uspharmacist.com]

Preliminary studies concerning Parkinson's disease suggested that vitamin E (2,000 IU/day) probably cannot prevent the development of the disease. It was suggested that vitamin E is able to slow the progression of the illness. [link.springer.com]

They are unable to make the appropriate kinetic-postural adjustment necessary to prevent them from falling. [dartmouth.edu]