Treatment of extrapyramidal syndrome

The extrapyramidal system is part of the motor system. Phylogenetically ancient part of the nervous system. The main function is to regulate muscle tone under the control of the cerebral cortex, maintain and adjust body posture, and control habitual and rhythmic movements such as arm swinging while walking, imitation, gestures, facial expressions, certain defensive reaction movements, etc. Let’s take a look at the treatment of extrapyramidal syndrome.

A related disease

(1) Parkinson's disease and various Parkinson's syndromes;

(2) Chorea;

(3) Chronic progressive chorea or Huntington's disease

(4) Wilson's disease;

(5) Abnormal muscle tone;

(6) Tourette syndrome;

(7) Tardive dyskinesia;

(8) Throwing dance;

(9) Paroxysmal choreoathetosis or paroxysmal kinesiogenic choreoathetosis, torsion spasm, etc.

2. Treatment and manifestations

It mainly includes two aspects, namely dystonia and dyskinesia. Dystonia is manifested as increased or decreased muscle tone; movement disorders include tremor, athetosis, choreiform movements, torsion spasms, etc. The decreased muscle tone caused by extrapyramidal diseases is often accompanied by involuntary movements (excessive movement). Patients present with irregular, arrhythmic, continuous activity and slow, complex involuntary movements. This movement occurs when the person is awake, increases when the person is emotionally excited, decreases when the person is quiet, and disappears during sleep. A typical case is chorea. The other group was characterized by increased muscle tone and bradykinesia. A typical case is Parkinson's syndrome. The causes of movement disorders and dystonia are: the striatum in the human brain contains a variety of neurotransmitters, among which dopamine and its metabolite homovanillic acid (HVA) have the highest content, and it also contains high concentrations of acetylcholine, γ-aminobutyric acid, 5-hydroxytryptamine and norepinephrine. There are two major ascending dopaminergic neural pathways in the brain. The largest is the nigrostriatal tract, whose neurons are located in the substantia nigra compacta and whose main function is related to the initiation and control of movement. The other is the mesolimbic pathway. Dopamine is an inhibitory mediator of the striatal acetylcholine system, while acetylcholine is an excitatory mediator of the striatum. The two mediators are in a state of dynamic equilibrium. If the substantia nigra is diseased, the ascending dopaminergic neural pathway is blocked, the reduction or loss of dopamine causes the striatum to lose its inhibitory effect, and the excitatory effect of acetylcholine is relatively enhanced, resulting in clinical manifestation of tremor. Experiments have shown that electrical stimulation of the globus pallidus or thalamus can induce characteristic resting tremors in patients with Parkinson's syndrome. Therefore, Parkinson's syndrome can be treated with levodopa plus decarboxylase inhibitors and anticholine drugs. Surgical destruction of the lateral ventral nucleus of the thalamus, motor cortex, or globus pallidus can also interrupt resting tremor.

After reading the above introduction to extrapyramidal syndrome, do you know that the extrapyramidal system is part of the motor system and is responsible for the movement and coordination of the limbs? If the extrapyramidal system is injured, the various parts of the body will not move freely and in a coordinated manner, and there will be local stiffness or other phenomena. Therefore, the extrapyramidal system is a very critical part. Therefore, we must protect the external system from harm.