EXTRAPYRAMIDAL SYSTEM DISORDERS - PowerPoint PPT Presentation

Loading...

PPT – EXTRAPYRAMIDAL SYSTEM DISORDERS PowerPoint presentation | free to download - id: 404ff3-MGVmO



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

EXTRAPYRAMIDAL SYSTEM DISORDERS

Description:

... Continous unsustained rapid abrupt and random contractures Small fidgety movements Distal muscles involved CAUSES Huntingtons disease Drugs Rx of ... – PowerPoint PPT presentation

Number of Views:69
Avg rating:3.0/5.0
Slides: 70
Provided by: Maimoona8
Learn more at: http://www.kau.edu.sa
Category:

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: EXTRAPYRAMIDAL SYSTEM DISORDERS


1
(No Transcript)
2
EXTRAPYRAMIDAL SYSTEM DISORDERS
3
  • BASAL GANGLION DYSFUNCTION

4
  • ANATOMY
  • Caudate nucleaus
  • Putamen
  • Globus pallidus
  • Substantia nigra
  • Subthalamic nuleus
  • Thallamus

5
(No Transcript)
6
(No Transcript)
7
  • EFFECTS OF DYSFUNCTION IN GENERAL
  • Involuntary movements
  • Altered movements
  • slow
  • Interrupted
  • Uncordinated
  • Posture and tone altered

8
  • MOVEMENT DISORDERS
  • BRADYKINETIC ---TOO LITTLE
  • Parkinson disease
  • Wilsons disease
  • Huntingtons disease

9
  • HYPERKINETIC TOO MUCH
  • Athetosis
  • Hemiballismus
  • Dystonia
  • Dyskinesia
  • Chorea
  • Myoclonus
  • Tremors
  • Tics

10
  • NEUROTRANSMITTERS
  • Dopamine gt Ach hyperkinetic
  • Ach gt dopamine hypokinetic

11
  • CAUSES OF EXTRAPYRAMIDAL DISORDERS
  • Drugs---chlorpromazine
  • ---butyrophenons
  • ---metochlorpramide
  • ---reserpine

12
  • Causes cont.
  • ToxinsCO and manganese poisoning
  • Inherited and metabolic disorders
  • wilsons disease
  • spinocerebellar ataxia
  • Encephalitis lethargica
  • Diffuse small vascular disease

13
  • Causes cont.
  • Inherited or degenerative disease
  • huntingtons disease
  • progressive supra nuclear gaze palsy
  • Steel Richardson

14
  • PARKINSONS DISEASE
  • Effects dopaminergic neurons
  • Neurons are lost from substantia nigra
  • Rarely presents before 50 years
  • Neurodegenerative disease
  • Equal sex distribution

15
  • CLINICAL FEATURES
  • Characterized by
  • Tremors
  • Rigidity
  • bradykinesia

16
  • TREMORS
  • Rest tremor
  • Starts in the thumb
  • Adduction and abduction of the thumb
  • Pill rolling
  • Tremors may effect the legs, mouth or the tongue

17
  • RIGIDITY
  • Leadpipe or plastic
  • Cogwheel
  • BRADYKINESIA
  • Slow movements
  • Develop gradually
  • Impairement of fine movements

18
  • General clinical features
  • Slow and monotonous speech
  • Greasy skin
  • Expressionless face ---mask face
  • Infrequent blinking
  • Flexed posture
  • Reduced arm swing

19
  • Clinical features cont.
  • Gaitslow in initiating
  • ---rapid small steps tendency to run-
  • festination
  • ---shuffling
  • Impaired balance
  • Glabber tap

20
  • Clinical features cont.
  • Muscle power is normal
  • Reflexes normal
  • Sensations normal
  • Cognitive abnormality as the disease advances

21
  • INVESTIGATIONS
  • Clinical diagnosis
  • Exclude other causes pts who present before 50
    years
  • Brain CT scan or MRI

22
  • TREATMENT
  • Levodopa
  • Anticholinergic drugs
  • Amantadine
  • Dopamine agonistsbromocriptine, pergolide
  • COMT inhibitors (catechol-o-methyl
    transferase)tolcapone
  • MAO inhibitors--selegine

23
(No Transcript)
24
(No Transcript)
25
  • HUNTINGTONS DISEASE
  • Inherited disorder
  • Autosomal dominant
  • Males females equally affected
  • Presents during the 4th decade
  • Chorea which worsens with time
  • Cognitive disorders
  • Dementia

26
  • Cont.
  • Abnormal facial movement
  • Mood swings
  • Jaw clenching
  • Slurred speech
  • Difficulty in walking
  • Personality changes

27
  • Cont.
  • Abnormal facial movement
  • Mood swings
  • Jaw clenching
  • Slurred speech
  • Difficulty in walking
  • Personality changes

28
  • WILSONS DISEASE
  • Hepato lenticular disorder
  • Autosomal recessive
  • Treatable cause of parkinsonsim
  • Due to deposition of copper in basal ganglia
  • Onset during childhood rarely in adulthood

29
  • Cont.
  • Present with liver disease in childhood
  • Impaired concentration
  • Decling intellect
  • Behavioural problems
  • Involuntary movements
  • Generalized dystonia

30
  • Cont.
  • Ataxia
  • Kayser Fleicher ring
  • Diagnosis
  • Serum ceruloplasmin level
  • 24 hour urine for copper
  • LFT
  • Liver biopsy

31
  • HYPERKINETIC MOVEMENTS
  • large variety of hyperkinetic disorders
  • Most are organic
  • All movements disappear during sleep

32
  • CHOREA
  • Continous unsustained rapid abrupt and random
    contractures
  • Small fidgety movements
  • Distal muscles involved

33
  • CAUSES
  • Huntingtons disease
  • DrugsRx of parkinsonism , oral c.pills
  • SLE
  • Sydenhams chorea
  • Wilsons disease
  • Polycythemia
  • Friedricks ataxia

34
  • HEMIBALLISMUS
  • Throwing of the limbs on one side of the body
  • Usually due to CVA involving the subthalamic
    nucleus

35
  • MYOCLONUS
  • Simple jerky movements that are not co-ordinated
    or suppressible
  • CAUSES
  • Renal failure
  • Hepatic failure
  • Creutz feldt jacob disease
  • Subacute sclerosing panencephalitis

36
  • DYSTONIA
  • Repeated patterned twisting and sustained
    movements that may be either slow or rapid
  • Involuntary movements occur before 20 years

37
  • Dystonia Cont.
  • Disturbance of the affected muscle groups
  • depend upon age
  • --distally---in children
  • ---cranial - cervical ---adults

38
  • Dystonia cont.
  • Primary----focal----torticollis
  • ----writers cramps
  • generalized
  • Secondary----wilsons disease
  • ----toxins

39
  • ATHETOSIS
  • Writhing movements
  • Mainly due to cerebral palsy
  • DYSKINESIA
  • Tardivedrugs-gt 6 wks exposure to dopamine
    agonists
  • Orofacial repeated movements

40
  • TREMORS
  • Physiological
  • Familial
  • Restingparkinsons disease
  • Intention or action ---cerebellar

41
  • TICS
  • Brief stereotyped supressible movements
  • Worse with stress
  • Cause
  • Dopamine excess causes inhibition of limbic
    system
  • Rx
  • Dopamine agonist

42
(No Transcript)
43
(No Transcript)
44
(No Transcript)
45
(No Transcript)
46
(No Transcript)
47
(No Transcript)
48
(No Transcript)
49
(No Transcript)
50
(No Transcript)
51
(No Transcript)
52
(No Transcript)
53
(No Transcript)
54
(No Transcript)
55
(No Transcript)
56
(No Transcript)
57
(No Transcript)
58
(No Transcript)
59
(No Transcript)
60
(No Transcript)
61
(No Transcript)
62
(No Transcript)
63
(No Transcript)
64
(No Transcript)
65
(No Transcript)
66
(No Transcript)
67
(No Transcript)
68
(No Transcript)
69
(No Transcript)
About PowerShow.com