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Extrapyramidal motor
Excitatory neurotransmitter : glutamate, aspartate Neurotransmitter : Glu, Ach, DA, GABA, 5HT
Neuropeptide : SP,enkephalin,CKK
PERIPHERAL MOTOR NS :
Corticobulbar tract =
corticonuclear tract
to the contra / ipsilateral
nuclei of the cranial motor nerves
( N. V, VII, IX, X, XI, XII )
Broadmanns area 8
nuclei of the N. III, IV, VI
Type of paralysis
Monoparesis
Paraparesis
Hemiplegia alternans :
weakness in one or more ipsilateral cranial nerves and
contralateral paralysis of the arm & leg
Hemiplegia alternans :
weakness in one or more ipsilateral cranial nerves
And contralateral paralysis of the arm & leg
Hemiplegia cruciata
Isolated paralysis (1 muscle groups)
Cerebral peduncles
Brain stem
Spinal cord
Plexus
Peripheral nerves
3. Nuclear *
Motor neurons / nuclei of the cranial nerves
4. Muscle disease
5. Neuromuscular-junction
Tendon
reflexes
UMN
LMN
Nuclear
Muscle Dis
NMJ
Spastic
Clonus
Flaccid/
/
normal
hypo/atoni
a
Impaired /
(-)
(-)
(-)
(-)
(-)
(-)
/ (-)
/ (-)
Cutaneus
Reflexes
/ (-)
Pathologic
Reflexes
Muscle
atrophy
(-) / <<
(disused
atrophy)
+Fasciculation
Mesencephalon
= hemiplegia
alternans superior
= Webers
syndrome
Pons
= hemiplegia
alternans inferior
= MillardGublers
syndrome
Med.oblongata
Mesencephalon Lesions
Hemiplegia alternans superior = Webers syndrome
Contralateral lesion hemiplegia
Ipsilateral lesionN. III palsy
Pons Lesions
Hemiplegia alternans inferior= MillardGublers syndrome
Contralateral lesion hemiplegia
Ipsilateral lesion N. VI, VII palsy
Contralateral gaze palsy
Med.oblongata
Lesions
Contralateral
lesion
hemiplegia
Ipsilateral lesion
N. XII palsy
= pallidum = paleotriatum
Putamen
= neostriatum = striatum
Parkinsons Disease
Degeneratif process hereditary
Loss of melanin containing neurons of substantia nigra
& of dopaminergic neurons that connect with the striatum
Bilateral
Unilateral
Chorea
short, fast, jerky movements
distal proximal portion of the extremities
Chorea minor
= Sydenhams chorea
= St Vitus dance
- in children
- acute, selflimiting
- linked to rheumatic fever ( = chorea infectiosa)
Chorea gravidarum
- acute chorea
- early pregnancy
Huntingtons chorea = chorea major
dominant, hereditary, degenerative disease
middle age
cortical neuron degenerate dementia
Athetosis
Continuous, arrhytmic, slow, wormlike
movements
Distal portion of the extremities
Posture & movement are bizarre
Caused by perinatal damage to the striatum