Presentation
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]
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]
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]
Clinical features spasticity Rigidity( lead pipe/ cog wheel) Reflexes brisk normal Power diminished Usually not affected Planters extensor flexor Involuntary movements absent present 7. Phylogenetically, corpus striatum is primarily responsible for [slideshare.net]
Entire Body System
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Progressive Dementia
This condition is most remarkable for vivid and severe hallucinations early in the condition, along with confusion, a progressive dementia and parkinsonian features. [dartmouth.edu]
Musculoskeletal
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Small Hand
Amyotrophy of the small hand muscles was found in six subjects. Assessment of associated features provided no evidence that cerebral vascular disease might be the cause of the combination of dementia with extrapyramidal features. [karger.com]
Psychiatrical
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Hysteria
These tactile maneuvers may lead physicians to the erroneous diagnosis of malingering or hysteria. [pocketdentistry.com]
Onset
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Onset in Adolescence
We report on 2 sibs with consanguineous parents, and an identical progressive extrapyramidal movement disorder with onset in adolescence and associated with progressive alopecia and primary hypogonadism. [ncbi.nlm.nih.gov]
Neurologic
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Extrapyramidal Symptoms
Treatments include: Medications Medications are the primary treatment of extrapyramidal symptoms. [healthfoxx.com]
Extrapyramidal symptoms caused by these agents are indistinguishable from neuroleptic-induced extrapyramidal symptoms. [ncbi.nlm.nih.gov]
symptoms. [2] Since it is difficult to measure extrapyramidal symptoms, rating scales are commonly used to assess the severity of movement disorders. [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]
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Focal Seizure
Dysphasia and right-sided hemiplegia became apparent; these conditions were and remained permanent, accompanied by focal seizures and a marked cognitive delay. [ncbi.nlm.nih.gov]
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Unable to Walk
The neurological deterioration was gathering pace so that she was soon unable to walk without bilateral support around the house and required a wheelchair for longer distances. [jnnp.bmj.com]
Workup
Other Pathologies
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Neurofibrillary Tangle
There may be large, ballooned neurons and other neurons containing neurofibrillary tangles. [dartmouth.edu]
Biopsy
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Liver Biopsy
WILSON’S DISEASE“Hepato-Lenticular Degeneration” : WILSON’S DISEASE“Hepato-Lenticular Degeneration” INVESTIGATIONS : Liver-Renal functions Copper studies Slit-lamp test Liver biopsy TREATMENT : Penicillamine Trientin Zinc compounds PARKINSON’s DISEASE [authorstream.com]
Treatment
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]
Prognosis
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
[…] 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]
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]
Epidemiology
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]
EPIDEMIOLOGY Studies of movement symptoms in patients taking neuroleptics for schizophrenia show prevalence rates ranging from .5% to nearly 70%. [medicalnewstoday.com]
Pathophysiology
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]
Akathisia Not a lot is known about the pathophysiology of akathisia. It is described as a “feeling of inner restlessness.” [learn.pharmacy.unc.edu]
DEFINITION ANATOMY FUNCTIONS APPROACH TO A CASE OF EXTRAPYRMIDAL DISORDER • CLASSIFICATION OF EXTRAPYRMIDAL DISORDER • DEFINATION • ETIOLOGY • PATHOPHYSIOLOGY • DISTINGUISHING FEATURES BRIEF DISCUSSION ON • PARKINSONISM • HUNTINGTON’ DISEASE [slideshare.net]
Because it is reversible and not progressive or fatal, very little is known of the pathophysiology. [dartmouth.edu]
Prevention
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]
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]
Patients taking these medications need to be monitored carefully to prevent potentially irreversible side effects. [medicalnewstoday.com]