Edit concept Create issue ticket

Pyramidal Tract Lesion


Presentation

  • Description An 85-year-old man with type 2 diabetes mellitus presented to our emergency department with sudden right limb weakness and dysarthria 90 min after onset. He was alert when examined and had a blood pressure of 163/89 mm Hg.[casereports.bmj.com]
  • This heavily revised new edition provides complete coverage of the nervous system including anatomic and physiologic presentation of disorders, recommended examination procedures, neurodiagnostic and laboratory testing, diagnostic reasoning, and neurologic[books.google.com]
  • 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]
  • Our patient presented with secondary seizures, as previously reported by Hinchey et al. [ 1 ] , that resulted in signal changes along the pyramidal tracts.[em-consulte.com]
  • Design/Methods: Review of clinical presentations and brain MRIs.[neurology.org]
Cheyne-Stokes Respiration
  • Deep anaesthesia Pathological causes of Babinski sign in absence of Pyramidal Tract Lesion Narcotic overdose Alcohol intoxication Following electroconvulsive therapy Coma secondary to metabolic disturbances Post-traumatic states Post-ictal state In Cheyne-Stokes[notes.medicosnotes.com]
Renal Artery Stenosis
  • There was no evidence of renal artery stenosis or adrenal tumor. Blood pressure was controlled with medication for a period of 6 months, and the patient was also given anticonvulsive therapy.[em-consulte.com]
Hyperreflexia
  • Symptoms include an increase in the muscle tone in the lower extremities, hyperreflexia, positive Babinski and a decrease in fine motor coordination.[sideeffects.embl.de]
  • Interruption of corticospinal fibers rostral to the motor (pyramidal) decussation causes impairment of movement in the opposite body-half, which is especially severe in the arm and leg and is characterized by muscular weakness, spasticity and hyperreflexia[medical-dictionary.thefreedictionary.com]
  • There is hypertonia (increased muscle tone, stiffness), hyperreflexia (exaggerated reflexes), and an oscillatory movement known as clonus .[courses.washington.edu]
  • (Ottawa) Hyperreflexia from Dr.[library.med.utah.edu]
  • On exam there is a combined deficit of vibration and proprioception with pyramidal signs (plantar extension and hyperreflexia).[forums.studentdoctor.net]
Clonus
  • In a patient with clonus, a muscle stretch elicits alternating contractions of agonist and antagonist muscle groups.[courses.washington.edu]
  • The cardinal signs of an upper motor neurone lesion are: Hypertonia – an increased muscle tone Hyperreflexia – increased muscle reflexes Clonus – involuntary, rhythmic muscle contractions Babinski sign – extension of the hallux in response to blunt stimulation[teachmeanatomy.info]
  • In a few days to a few weeks, flaccidity gradually gives way to spasticity at the same time that the tendon reflexes reappear and eventually become hyperactive, as indicated by foot clonus and Hoffmann’s sign 17 .[jneurology.com]
  • Primary lateral sclerosis The age of onset for primary lateral sclerosis (PLS) is usually between 40 and 60 years, with spasticity in the legs accompanied by hyperactive deep tendon reflexes, clonus, and Babinski sign.[emedicine.medscape.com]
Spastic Paralysis
  • Facial nerve – a lesion to the upper motor neurones for CN VII will result in spastic paralysis of the muscles in the contralateral lower quadrant of the face.[teachmeanatomy.info]
  • Pure spastic paralysis of corticospinal origin. Can J Neurol Sci. 1977; 4: 251-258. Jagiella WM, Sung JH. Bilateral infarction of the medullary pyramids in humans. Neurology. 1989; 39: 21-24. Meyer JS, Herndon RM.[jneurology.com]
Spastic Paraplegia
  • Of the 45 known gene loci, 20 have been identified as causative. [57] About 40% of autosomal dominant HSP cases are linked to the spastic paraplegia 4 (SPG4) locus on chromosome 2p21-p22.[emedicine.medscape.com]
Pyramidal Tract Signs
  • Neurological examination revealed bilateral pyramidal-tract signs, and paresis of the right arm.[em-consulte.com]

Treatment

  • You'll confidently identify the signs and symptoms of disease, know when additional diagnostic testing is indicated, accurately interpret diagnostic data, and recommend effective treatment options.[books.google.com]
  • It is not intended as a substitute for professional medical advice, diagnosis or treatment.[sideeffects.embl.de]
  • […] clinical assessments and outcome measurements fail to accurately predict treatment response ( 5 ).[frontiersin.org]
  • Conclusions: Corticospinal tract lesions have a heterogenous etiology, with widely different treatments and prognoses. An understanding of these potential etiologies will assist neurologists confronted with this imaging finding.[neurology.org]
  • Página 470 - Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. ‎[books.google.es]

Prognosis

  • 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]
  • 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

  • Conclusions: Corticospinal tract lesions have a heterogenous etiology, with widely different treatments and prognoses. An understanding of these potential etiologies will assist neurologists confronted with this imaging finding.[neurology.org]
  • 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]

Epidemiology

  • 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]
  • Cerebral Palsies: Epidemiology and Causal Pathways . London: MacKeith Press (2000). 251 p. Google Scholar 2. Himmelmann K, Hagberg G, Uvebrant P. The changing panorama of cerebral palsy in Sweden. X.[frontiersin.org]
Sex distribution
Age distribution

Pathophysiology

  • There are three pathophysiological aspects.[em-consulte.com]
  • The views herein discussed reconcile several apparent incongruences concerning the pathophysiology of the human pyramidal syndrome.[jneurology.com]
  • Cortical excitability and neurology: insights into the pathophysiology. Funct Neurol (2012) 27 (3):131–45. PubMed Abstract Google Scholar 55. Gilbert DL, Garvey MA, Bansal AS, Lipps T, Zhang J, Wassermann EM.[frontiersin.org]

Prevention

  • […] hypoglycaemic hemiplegia lesions might be present along the pyramidal tract, since the more compact neuronal tissue might be more vulnerable to hypoglycaemia. 3 The coronal section in this case shows that the lesion is actually along the pyramidal tract and, to prevent[casereports.bmj.com]
  • Collaborative Meta-Analysis of Randomised Trials of Antiplatelet Therapy for Prevention of Death, Myocardial Infarction, and Stroke in High Risk Patients. ‎[books.google.es]
  • Because the interneuron is inhibitory, it prevents the opposing alpha motor neuron from firing, thereby reducing the contraction of the opposing muscle.[nba.uth.tmc.edu]
  • Termination of the trajectory occurs when d N falls below a threshold value which is set so as to prevent the trajectory entering the grey matter.[jnnp.bmj.com]
  • Centers for Disease Control and Prevention (CDC). Economic costs associated with mental retardation, cerebral palsy, hearing loss, and vision impairment – United States, 2003. MMWR Morb Mortal Wkly Rep (2004) 53 (3):57–9. Google Scholar 4.[frontiersin.org]

Ask Question

5000 Characters left Format the text using: # Heading, **bold**, _italic_. HTML code is not allowed.
By publishing this question you agree to the TOS and Privacy policy.
• Use a precise title for your question.
• Ask a specific question and provide age, sex, symptoms, type and duration of treatment.
• Respect your own and other people's privacy, never post full names or contact information.
• Inappropriate questions will be deleted.
• In urgent cases contact a physician, visit a hospital or call an emergency service!