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Pyramidal Tract Disorder


Presentation

  • One month later she presented with mild dysarthria and mild left hemiparesis. Brain MRI disclosed an extensive pyramidal tract lesion from the right corona radiata to the pedunculus cerebri.[jstage.jst.go.jp]
  • Corticospinal tract syndrome ..• The changes may includes: Muscle weakness Decrease motor control including decrease speed and accuracy Spasticity Babinski sign and Ankle clonus is present Deep tendon reflexes are increased or present Clasp-knife response[slideshare.net]
  • At the beginning spinal shock is present due to cessation of supraspinal innervation of α-motoneuron. Muscles become flaccid and no reflexes are present (areflexia). In time (regeneration) synapses are established within the spinal cord.[wikilectures.eu]
  • In the first family, clinical presentation mimicked familial spastic paraplegia.[ajnr.org]
  • Although slight bilateral facial weakness was present, other cranial nerves were intact. Severe muscle weakness was present in the neck and the proximal portion of the bilateral lower extremities.[jnnp.bmj.com]
Torticollis
  • Acute dystonic reaction involves muscular spasm of the neck known as torticollis. The patient experiences severe pain on the neck when trying to move it. The eyes may also be affected leading to oculogyric crisis.[healthfoxx.com]
  • So knock out the pyramidal "motherboard" and you cant move (weakness) but knock out the EPS "adjusters" and you can still move, but you'll move funny (ataxia) or get stuck (rigidity, bradykinesia, torticollis) or randomly flail (hemiballism) or have an[forums.studentdoctor.net]
  • Focal dystonias include writer’s cramp, orofaciomandibular dystonia, and torticollis. Tics are similar to dystonia, but they consist of brief movements or utterances of unknown cause.[britannica.com]
Motor Restlessness
  • Benzodiazepines – Benzodiazepines such as valium may also be given to stabilize the nerve impulse transmission to reduce motor restlessness.[healthfoxx.com]
Akathisia
  • These symptoms include: Akathisia. Akathisia is a condition of motor restlessness. Akathisia may involve urge to move constantly, inability to sit still, or feeling of shakiness or jitterness.[healthfoxx.com]
  • […] extrapyramidal G25.9 ganglion (basal ganglia brain) G25.9 ICD-10-CM Codes Adjacent To G25.9 G25.69 Other tics of organic origin G25.7 Other and unspecified drug induced movement disorders G25.70 Drug induced movement disorder, unspecified G25.71 Drug induced akathisia[icd10data.com]
  • Extrapyramidal signs/symptoms are due to the side effects from dopamine blockade such as Dyskinesias (pseudoparkinsonism, dystonia, akathisia, tardive dyskinesia). Hope this helps.[forums.studentdoctor.net]
Spastic Gait
  • SPASTIC GAIT Stiff legged, circumduction, decreased arm swing, unsteady Corticospinal tracts Describe and give location of impairment for...[quizlet.com]
  • Spastic gait can be unilateral or bilateral corticospinal tract involvement and appears as stiff-legged circumduction, sometimes scissoring of the legs and toe-walking, a decreased arm swing, unsteady falling toward one side, and can be seen in cortical[accessphysiotherapy.mhmedical.com]
Bilateral Ankle Clonus
  • Physical examiniations revealed hyperactive reflexes, bilateral ankle clonus and positive Babinski sign in the right. DTI showed reduced white matter integrity of the corticospinal tract in the frontal lobe and subpontine plane.[bmcneurol.biomedcentral.com]
Postural Instability
  • Affectation of which may result in bradykinesia or slow movements, lead-pipe rigidity, postural instability, mask like face, shuffling gait and resting tremor that are similar to true Parkinson’s disease. Tardive Dyskinesia.[healthfoxx.com]
Lip Smacking
  • Tardive dyskinesia may include lip smacking, fly-catching movement of the tongue, eye blinking, finger movements and arm and leg movements. Tardive dyskinesia is usually recognizable.[healthfoxx.com]

Treatment

  • Treatments include: Medications Medications are the primary treatment of extrapyramidal symptoms.[healthfoxx.com]
  • .• Introduction• Anatomy of corticospinal tract• Corticospinal tract syndrome Causes Assessment Treatment 3.[slideshare.net]
  • Contarino Source Type: research Deep Brain Stimulation (DBS) is an effective treatment in selected cases of Parkinson's disease (PD).[medworm.com]
  • An orthopedic surgeon requires a definition of the limbs affected and the extent of impairment in order to prescribe treatment.[cerebralpalsy.org]
  • The trihexyphenidyl and baclofen treatment provided limited benefits to the patient. In the future, therapies aimed at the Na /K -ATPase pump may be effective treatments for RDP.[bmcneurol.biomedcentral.com]

Prognosis

  • […] hyperintensity in the corticospinal tracts (specificity 6 GRE/SWI: hypointensity in the precentral gyrus bilaterally, known as the " motor band sign " 8,9 MR spectroscopy 2 decreased NAA decreased glutamate increased choline increased myo-inositol Treatment and prognosis[radiopaedia.org]
  • Patients who have sustained damage to their corticospinal tract have a prognosis that varies, depending on the nature of the damage. Some patients may be able to regain motor control over the course of the healing process.[wisegeek.org]
  • Prognosis Clin Obstet Gynecol. 2008 Dec;51(4):816-28. JAMA. 2002 Sep 18;288(11):1357-63. Pediatrics. 2011 Aug;128(2):e299-307. Dev Med Child Neurol. 2008 Jul;50(7):487-93.[pathophys.org]
  • This review was limited to the topics described above because other topics relevant to brain rehabilitation, such as recovery mechanisms or prognosis prediction using transcranial magnetic stimulation (TMS) or diffusion tensor imaging (DTI) have been[medicaljournals.se]
  • This distinction is important for genetic counseling of family members and for the patient’s prognosis, in that HSP generally carries a more favorable prognosis. [2] Other components of the differential diagnosis of HSP are similar to those of PLS.[emedicine.medscape.com]

Etiology

  • Although its etiology remains unknown, in a few cases, it seemed to be secondary to transient postoperative peri-lead edema [2].[medworm.com]
  • Primary lateral sclerosis The etiology of primary lateral sclerosis (PLS) is unknown, but it may be similar to that proposed for ALS.[emedicine.medscape.com]
  • Etiology Clin Obstet Gynecol. 2008 Dec;51(4):775-86. Pediatr Neurol. 2009 Mar;40(3):168-74.[pathophys.org]
  • Enzyme deficiencies are the cause of some cases of hereditary motor neuropathy, but in most cases the etiological basis of the disease is unknown.[britannica.com]

Epidemiology

  • To date, epidemiological data related to RDP is limited and fewer than 75 RDP cases have been reported worldwide [ 2 ].[bmcneurol.biomedcentral.com]
  • Epidemiologic data suggest that smoking may be an established risk factor for sporadic ALS. [8] The peak age of onset is between 55 and 75 years.[emedicine.medscape.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiological mechanisms responsive for the hyperexcitability of the myotatic reflex can be studied by methods of clinical neurophysiology.[ncbi.nlm.nih.gov]
  • We suppose that findings of the current study may provide further insights to what extent PD and ET have similar or different pathophysiology in M1 and whether the microstructure of the CST is related to the M1 pathophysiology.[journals.plos.org]
  • Pathophysiology Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F153-61.[pathophys.org]
  • The identification and characterisation of ADSA offers a unique perspective of the pathophysiology of ataxic diseases on the whole. Acknowledgments We are greatly indebted to the family involved for their participation.[jmg.bmj.com]

Prevention

  • Corticosteroids reduce the risk of CP, as steroids inhibit cytokine production, thus preventing PVL. Pathophysiology Arch Dis Child Fetal Neonatal Ed. 2008 Mar;93(2):F153-61.[pathophys.org]
  • […] sometimes be used to help with dysmetria (poor coordination of movements) Long-term management for FAHN can include: Nutrition Monitoring of height and weight in children Swallowing evaluation and regular dietary assessments Assure adequate nutrition Prevent[nbiacure.org]
  • The loss of such input to the ventral horn of the spinal cord would obviously prevent those neurons from discharging in a meaningful sequence. Hence, such a loss would result in paralysis of movement.[what-when-how.com]
  • Preventive medications include tricyclics, adrenergic blocking agents, and lithium.[britannica.com]
  • […] universally accepted classification system, such as the Gross Motor Function Classification System, or GMFCS, to increase consistency in studies worldwide and to expand the ability to build knowledge around prevalence, life expectancy, societal impact, prevention[cerebralpalsy.org]

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