DISEASES OF BASAL GANGLIA AND EXTRAPYRAMIDAL SYSTEM

DEFINITION

This is a syndrome characterised by poverty of movement (akinesia), rigidity of muscles and tremor.

CLASSIFICATION AND CAUSES OF PARKINSONISM

1. Idiophatic Parkinsonism or paralysis agitans- commonest.

2. Post-encephalitic Parkinsonism which results from encephalitis lethargica which is rare how-a-days.

3. Pseudo-Parkinsonism including arteriosclerosis and familial tremor.

4. Juvenile Parkinsonism : This includes mainly hepatolenticular degeneration but also Haller-vorden-Spatz disease and Huntington’s chorea.

5. Secondary Parkinsonism due to trauma, space occupying lesion, neurosyphilis, tuberculosis, ischaemic process, haemorrhage and kernicterus. Usually substantia nigra is involved.

6. Iatrogenic and toxic Parkinsonism : Phenothiazine derivatives, metoclopramide, prochlorperazine, reserpine, manganese, mercury, carbon monoxide, carbon-disulphide, MPTP (a synthetic substance).

7. Parkinsonism-Plus Various degenerative diseases of the central nervous system are included -Creutzfeldt –Jacob disease, Progressive supranuclear palsy or Steel-Richardson-Olszewsky syndrome. Olivoponto-cerebellar atrophy and Shy-Drager syndrome.

8. Childhood akinetic rigid syndromes.

DISEASES OF BASAL GANGLIA AND EXTRAPYRAMIDAL SYSTEM

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