scholarly journals Syndromology lesions of the extrapyramidal system (Translation Section «Clinical Neurology», 4th Edition (2014), T.J. Fowler,John W. Scadding,Nick Losseff, J.W.Scadding)

Author(s):  
I. Kucheieva

The term “movement disorders” has come to be applied to those diseases of the nervous system, mostly of the basal ganglia, which cause disturbances of movement which cannot be attributed to sensory loss, weakness or spasticity, or obvious cerebellar ataxia.

Author(s):  
Mark J. Edwards ◽  
Penelope Talelli

For video material relating to movement disorders, please go to Movement Disorders Videos. Less is known of the function of the cerebellum, thalamus and basal ganglia than of other structures in the brain, but there is an increasing appreciation of their complex role in motor and nonmotor functions of the entire nervous system. These structures exercise functions that far exceed their previously assumed supporting parts as simple ‘relay stations’ between cortex and spinal cord....


Author(s):  
Robertus M. A. de Bie ◽  
Susanne E. M. Ten Holter

Corticobasal syndrome is a clinical diagnosis based on the presence of one or more movement disorders suggestive of basal ganglia dysfunction, typically asymmetrical, with evidence of associated cortical dysfunction. This is a pathologically heterogeneous group of disorders that can share a common phenotype. Corticobasal degeneration is one of these pathologies, representing one of the rarest forms of atypical parkinsonism. When confronted with a patient with higher cortical dysfunction, specific assessment for apraxia, cortical sensory loss, and cognition is indicated. Corticobasal syndrome is currently untreatable, regardless of the nature of the underlying pathology, and in most cases progression is fast with significant disability that is typically unresponsive to levodopa.


2000 ◽  
Vol 5 (2) ◽  
pp. 3-3
Author(s):  
Christopher R. Brigham ◽  
James B. Talmage

Abstract Lesions of the peripheral nervous system (PNS), whether due to injury or illness, commonly result in residual symptoms and signs and, hence, permanent impairment. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) describes procedures for rating upper extremity neural deficits in Chapter 3, The Musculoskeletal System, section 3.1k; Chapter 4, The Nervous System, section 4.4 provides additional information and an example. The AMA Guides also divides PNS deficits into sensory and motor and includes pain within the former. The impairment estimates take into account typical manifestations such as limited motion, atrophy, and reflex, trophic, and vasomotor deficits. Lesions of the peripheral nervous system may result in diminished sensation (anesthesia or hypesthesia), abnormal sensation (dysesthesia or paresthesia), or increased sensation (hyperesthesia). Lesions of motor nerves can result in weakness or paralysis of the muscles innervated. Spinal nerve deficits are identified by sensory loss or pain in the dermatome or weakness in the myotome supplied. The steps in estimating brachial plexus impairment are similar to those for spinal and peripheral nerves. Evaluators should take care not to rate the same impairment twice, eg, rating weakness resulting from a peripheral nerve injury and the joss of joint motion due to that weakness.


2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii330-iii331
Author(s):  
Hirokazu Takami ◽  
Koichi Ichimura ◽  
Kohei Fukuoka ◽  
Akitake Mukasa ◽  
Nobuhito Saito ◽  
...  

Abstract BACKGROUND We integrated clinical, histopathological, and molecular data of central nervous system germ cell tumors to provide insights into their management. METHODS Data from the Intracranial Germ Cell Tumor Genome Analysis Consortium were reviewed. A total of 190 cases were classified as primary GCTs based on central pathological reviews. RESULTS All but one of the cases that were bifocal (neurohypophysis and pineal glands) and cases with multiple lesions including neurohypophysis or pineal gland were germinomas (34 of 35). Age was significantly higher in patients with germinoma than other histologies. Comparison between tumor marker and histopathological diagnoses showed that 18.2% of histopathologically diagnosed germinomas were marker-positive and 6.1% of non-germinomatous GCTs were marker-negative, suggesting a limitation in the utility of markers or histopathology alone using small specimens for diagnosis. Comparison between local and central histopathological diagnoses revealed a discordance of 12.7%. Discordance was significantly less frequent in biopsy cases, implying difficulty in detecting all histopathological components of heterogeneous GCTs. Germinomas at the typical sites (neurohypophysis or pineal gland) showed a better PFS than those at atypical sites (p=0.03). A molecular-clinical association study revealed frequent MAPK pathway mutations in males (51.4 vs 14.3 %, p=0.007), and PI3K/mTOR pathway mutations in basal ganglia cases (p=0.004). Basal ganglia cases also had frequent chromosomal losses. Some chromosomal aberrations (2q, 8q gain, 5q, 9p/q, 13q, 15q loss) showed potential prognostic significance. CONCLUSIONS These in-depth findings of this study regarding the clinical and molecular heterogeneity will increase our understanding of the pathogenesis of this enigmatic tumor.


2007 ◽  
Vol 4 (5) ◽  
pp. 605-614 ◽  
Author(s):  
Sara Marceglia ◽  
Lorenzo Rossi ◽  
Guglielmo Foffani ◽  
AnnaMaria Bianchi ◽  
Sergio Cerutti ◽  
...  

2021 ◽  
Vol 11 (7) ◽  
pp. 1817-1824
Author(s):  
Ruyun Zou ◽  
Guiyou Liu

Epilepsy is caused by highly synchronized abnormal discharges of neurons in the brain. Resting State FMRI is widely used as a non-invasive checking method, clinical and basic research in the field of epilepsy has a huge influence, to study the plant nerve system movement function of brain activity and the neural network function of the complex contact provides broad prospects, greatly promote the development of clinical neurology and imaging. Therefore, this paper studies the functional connection and cognitive function of verbal working memory (VWM) in patients with epilepsy by applying resting state FMRI. The experimental results showed that VWM and cognitive functions of epileptic patients showed a trend of decline or even disappearance, to realize the detection of autonomic nervous system motor dysfunction of patients.


2021 ◽  
Vol 15 ◽  
Author(s):  
Jennifer L. Magnusson ◽  
Daniel K. Leventhal

Basal ganglia dysfunction is implicated in movement disorders including Parkinson Disease, dystonia, and choreiform disorders. Contradicting standard “rate models” of basal ganglia-thalamic interactions, internal pallidotomy improves both hypo- and hyper-kinetic movement disorders. This “paradox of stereotaxic surgery” was recognized shortly after rate models were developed, and is underscored by the outcomes of deep brain stimulation (DBS) for movement disorders. Despite strong evidence that DBS activates local axons, the clinical effects of lesions and DBS are nearly identical. These observations argue against standard models in which GABAergic basal ganglia output gates thalamic activity, and raise the question of how lesions and stimulation can have similar effects. These paradoxes may be resolved by considering thalamocortical loops as primary drivers of motor output. Rather than suppressing or releasing cortex via motor thalamus, the basal ganglia may modulate the timing of thalamic perturbations to cortical activity. Motor cortex exhibits rotational dynamics during movement, allowing the same thalamocortical perturbation to affect motor output differently depending on its timing with respect to the rotational cycle. We review classic and recent studies of basal ganglia, thalamic, and cortical physiology to propose a revised model of basal ganglia-thalamocortical function with implications for basic physiology and neuromodulation.


2020 ◽  
Author(s):  
Meng Wang ◽  
Baochang Qi ◽  
Jinming Han ◽  
Chunjie Guo ◽  
Limei Qu ◽  
...  

Abstract Background: Primary central nervous system lymphoma (PCNSL ) is a rare and aggressive malignant tumor. It is easy to be misdiagnosed due to its low incidence and unspecific presentations in clinical practice. PCNSL mainly occurs intracranially in the brain while spinal cord is rarely involved. Case presentation: Here we report a 76-year-old woman who had a suspicious tumor history and presented retardant paralysis, bladder dysfunction and sensory loss of the lower limbs. Magnetic resonance imaging (MRI) of the thoracic spine disclosed longitudinally extensive lesions extending from thoracic 4 (T4) to lumbar 1 (L1) vertebral level with an enhanced nodular lesion noting at levels of T10 and T11 . In order to further identify the cause, the whole body 18 F-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) was performed and showed a hypermetabolic nodule corresponded to MRI enhancing lesions, which further suggesting the possibility of a tumor. The patient then underwent a surgical resection and spinal cord biopsy confirmed the diagnosis of non-Hodgkin's lymphoma (diffuse large B-cell type). The patient then received a high-dose chemotherapy based on methotrexate combined with Rituximab. Unfortunately, the symptoms of this patient have not been improved significantly after three rounds of chemotherapy. Conclusion: Our case indicates that PCNSL may also serve as a possible cause for longitudinally extensive spinal cord lesions, especially the patients who had a suspicious tumor history, MRI enhancing lesion s in the spinal cord corresponded to hypermetabolic nodules on 18 F-FDG- PET/CT at the same level.


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