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2.1
Pyramidal Tract Disorder

Presentation

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 [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]

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]

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]

Neurologic

  • Spastic Gait

    SPASTIC CATCH? SUBTLE DECREASED NASOLABIAL FOLD? CAREFUL GAIT TESTING? Testing for UMN lesions... [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

    Ankle clonus was present bilaterally with more than 3 cloni. The right foot displayed a positive Babinski sign, whereas the left displayed a suspicious positive. Fig. 2 Prominent lower lip concavity in our patient. [bmcneurol.biomedcentral.com]

  • Generalized Seizure

    Generalized seizures The onset of generalized seizures is usually in the early years of life and may be caused by a genetic abnormality. [britannica.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]

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]

Preventive medications include tricyclics, adrenergic blocking agents, and lithium. [britannica.com]

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]

[…] 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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