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Extrapyramidal symptoms

, medical expert
Last reviewed: 23.04.2024
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Extrapyramidal symptoms appear due to violations in the extrapyramidal system. This is due to changes in muscle tone, the appearance of hyperkinesis, hypokinesia and impaired motor activity. There is all this in the defeat of special structures of the brain. These are the basal ganglia, the piedmont region, the optic hillock and the inner capsule. In the process of manifestation of symptoms, a special role is played by the violation of the neurotransmitter metabolism. It leads to a change in the balance between dopaminergic mediators and cholinergic mediators, as well as interrelationships with the pyramidal system. The system itself is concerned with ensuring the regulation of the posture, changing the muscle tone. The latter is responsible for the accuracy of movements, quickness, smoothness, swinging hands and feet when walking.

trusted-source[1], [2], [3], [4], [5], [6], [7], [8]

Symptoms of extrapyramidal disorders

Symptoms of extrapyramidal disorders mainly have subacute development, symmetry of manifestations, endocrine disorders. They are characterized by a non-progressive course, a slight severity and the absence of gross postural disorders.

  • Parkinsonism Syndrome. Symptoms include the difficulty of the initial movements, twists, excessive slowness, stiffness and muscle tension. The signs of the cogwheel, which consist in discontinuity and gradual movements, are not excluded. There is a tremor of extremities, drooling and masklike face. In the event that the symptomatology reaches a pronounced degree, an akinesia may develop. Sometimes there is a mutism and dysphagia. A typical tremor is rare, more common common tremor, which manifests itself in a state of rest and movement. Basically, Parkinson's syndrome affects the mental sphere. There comes emotional indifference, lack of pleasure from activity, anhedonia, inhibition of thinking, difficulty in concentrating attention, reducing energy. In some cases, there are secondary signs. They consist in an abulia, flattening of affect, poverty of speech, anhedonia and emotional isolation.
  • Acute dystonia. A clinical picture of the manifestations is characterized by a sudden onset of dystonic spasms of the muscles of the head and neck. Suddenly, there appears trismus, protruding tongue, opening the mouth, violent grimaces, torticollis with a turn, stridor. A number of patients have oculogic crises, which are characterized by violent friendly eyeballs. This process lasts from a few minutes to hours. Some patients develop blepharospasm or enlargement of the eye slits. If the trunk muscles are involved, then there is opisthotonus, lumbar hyperlordosis, scoliosis. As for motor disorders, they can be localized or generalized. The symptomatology consists in general motor excitation with affects of fear, anxiety and autonomic disorders. Dystonic spasms look repulsive. It is difficult to transfer them. Sometimes they are so pronounced that they can lead to dislocation of the joints.
  • Akathisia. It is an unpleasant feeling of restlessness. Man always needs to move. Patients become fussy, forced to constantly walk. They can not be in one place. Movement partially alleviates anxiety. The clinical picture includes a sensory and motor component. The first option is the presence of unpleasant internal sensations. Patients do not know what is happening to them, but they have to constantly move. They are filled with anxiety, inner tension, irritability. The motor component has other manifestations. A person can fidget in a chair, constantly change the pose, throw one's leg behind one's leg, knock with fingers, fasten and unbutton buttons, etc. Acacia can aggravate the condition of the patient. In this case, extrapyramidal symptoms are more pronounced.

The first signs of extrapyramidal disorders

The first signs of extrapyramidal disorders can be early and late. Much depends on a person's condition and his heredity. Some symptoms appear at the age of 30-40 years, others are characterized by an earlier picture-15-20 years.

Initially, a person begins to suffer irritability, increased emotionality. Over time, this adds to the nervous twitching of the face, limbs.

Primary signs of disorders are independent diseases. These can be diseases associated with the death of neurons and atrophy of certain structures of the brain. Among them are Parkinson's and Huntington's. Initially, a person has a tremor of extremities, profuse salivation and a masklike facial expression. A person is not able to concentrate attention. Over time, dementia and meager speech appear. There are also diseases, for which certain pathomorphological changes are characteristic. This is dystonia and tremor. The man twitches with his limbs. In addition, he can have spasms of the neck and head. Unexpectedly manifests itself trism. A man makes violent grimaces, his tongue protrudes. Over time, the first extrapyramidal symptoms progress, and the condition deteriorates significantly.

Symptoms of defeat of extrapyramidal system

Symptoms of destruction of the extrapyramidal system manifest themselves in different ways. In general, there is athetosis, chorea, torsion spasm, tick, myoclonia, hemiballism, facial hemispasm, Huntington's chorea, hepatocerebral dystrophy, Parkhonism.

  • Athetosis. It appears on the fingers. Man exercises petty, wriggling, vermiform movements. If the problem touched the muscles of the face, then everything manifests itself in the form of curvature of the mouth, twitching of the lips and tongue. The tension of the muscles is replaced by complete relaxation. This manifestation is typical for damage to the caudate nucleus of the extrapyramidal system.
  • Chorea. Man performs a variety of rapid violent movements of the muscles of the trunk and extremities, neck and face. They do not differ in rhythm and consistency. Appear against a background of reduced muscle tone.
  • Torsional spasm is the dystonia of the muscles of the trunk. The disease can occur at any age. The main manifestations are walking. These are folding, spinning, rotational in the neck and torso muscles. The first manifestations begin with the muscles of the neck. They are characterized by violent lateral turns of the head.
  • Teak is a constant twitching of individual muscles. More often it is noticeable on the face, eyelids and neck. The man throws back his head, pulls his shoulder, winks, wrinkles his forehead. All movements are of the same type.
  • Myoclonia. This is a quick short twitching. In some muscles they are lightning fast.
  • Hemiballism. These are one-sided throwing, sweeping movements of limbs (often hands). They occur when the luis body is injured.
  • Facial hemispasm. It is characterized by the reduction of the muscles of the face, tongue, and neck. At the same time, the person closes his eyes, pulls his mouth. Perhaps the manifestation of violent laughter, crying, the appearance of various grimaces. Cramps, violations of accuracy and purposefulness of movements are manifested.
  • Horea Huntington. This is a serious hereditary disease, it begins to manifest itself in 30-40 years. It is characterized by developing dementia. Degenerative process affects the shell, caudate nucleus, cells of the frontal lobe of the brain.
  • Hepatocerebral dystrophy is one of the hereditary diseases. It can begin at any age. Man begins to make a "flight of wings." The condition progressively worsens. To it mental disorders are added. It can be emotional lability, dementia.
  • Parkinsonism. This state is characterized by nonspecific movements, disturbances in mental processes and emotional poverty. All of the above is extrapyramidal symptoms that manifest themselves when the extrapyramidal system is violated.

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