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Results for “EXTRAPYRAMIDAL TRACTS”

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At least 73 records · Page 4Linked to original sources
PubMed1992

[Vesico-sphincteric disorders in patients with Parkinson's disease].

Vesicosphincteric disorders are frequent in patients with Parkinson's disease, due to a lesion of the locus niger of the extrapyramidal tract which no longer secretes sufficient dopamine to activate the nigrostriatal tract. The commonest symptoms are urgent micturition, dysuria or a combination of the two. 50% of patients with Parkinson's disease present with disturbances of micturition and these symptoms may be presenting complaint of the disease in 10% of cases. Cystomanometry reveals detrusor hyperactivity in more than 60% of cases and hypoactivity in less than 30% of case, while dyssynergia is less common. Delayed relaxation of the striated sphincter may sometimes be observed. Urological problems must therefore be distinguished from urological problems in these patients. A combined urological and urodynamic assessment is essential as the risk of incontinence following prostate surgery is 20%. Stress urinary incontinence in women may mask or be associated with urgency. These vesicosphincteric disorders must therefore be treated cautiously with a combination of medical treatment (dopatherapy increases detrusor control), retraining and occasionally surgery after a detailed urodynamic assessment.

Female↗
PubMed1992

Major neurological disease and occupational exposure to organic solvents.

Five patients are described who presented with major organic brain disease affecting one or more of pyramidal and extrapyramidal tracts, cerebellum, and higher cortical functions. All had a history of 10 years or more of regular occupational exposure to solvents in confined spaces, three in painting inside ships and the others in weapons maintenance and printing. All had been regularly exposed to high air vapour peaks as well as to skin contamination. Four showed some evidence of improvement after the exposure ceased. None was initially suspected of having a toxic encephalopathy by the consultant to whom he was referred. The spectrum of neurological disease presented by these men mirrors closely that described in solvent abusers. All were forced by illness to retire from their work, a circumstance which might have in the past have led to such conditions being missed in cross-sectional studies, which in general have not shown evidence of major disease. We suggest that when such disease occurs nowadays, its cause is usually not suspected. Further epidemiological study of the problem is necessary.

Humans↗
PubMed2005

[Spontaneous rupture of common iliac artery after hysterectomy for malignant gynecologic tumor].

Authors described a serious, iatrogenic, vessel complications after hysterectomy for uterus sarcoma. After successful abdominal hysterectomy spontaneous rupture of right common iliac artery occurred causing massive exsanguination into intraperitoneal space. During secondary laparotomy procedure large, partial loss of arterial wall was recognized and provided with non-absorbable Prolene 4-0 suture. Subsequently, the injury was replaced by arterial artificial prosthesis gore-tec 8. Intraoperatively, ventricular fibrillation and cardiac arrest took place with subsequent acute respiratory and circulatory distress syndrome. Throughout next several days after reoperation patient was deep unconscious and hospitalized on Intensive Care Unit. She manifested symptoms of damaged extrapyramidal tracts. In spite of further unfavourable prognosis, after almost a month of respiratory therapy, she fully recovered without symptoms of brain damage and visual sequelae.

Adult↗
PubMed1991

Changes in stainability observed by light microscopy in the brains of ataxial mice subjected to three generations of manganese administration.

Two neonates of mice which manifested abnormal motions in their gait in the third generation litter, following the start of manganese (Mn) administration, were selected. One was severely affected by Mn and the other was only moderately affected. Various regions in the brains of the neonates were subjected to histochemical examination under a light microscopy. The losses of stainability in granular cells in the external layer of the cerebral cortex, and Purkinje cells in the cerebellar cortex, and the increase in stainability of the nerve fibers in the cerebellar medulla were in parallel to the degree of abnormal movement in the gait; the greater loss or gain in stainability, varying according to the regions, was associated with the more severe damages to motion. Meanwhile, the changes in the stainabilities of nerve cell nuclei in the lamellar structure of cerebral motor areas and the Nissl bodies in the cerebral medulla were already maximal in the moderately affected neonate. These results indicate that the Mn effect covers a broad area of the extrapyramidal tract even though there are some differences in the sensitivity to Mn in different regions.

Animals↗
PubMed1991

[Clinical studies of 23 patients with multiple system atrophy presenting with vocal cord paralysis].

In order to elucidate the clinical features and the prognosis for life in the patients with multiple system atrophy (MSA) presenting with vocal cord paralysis (VCP), we studied the correlation between VCP and other neurological findings including cerebellar, pyramidal, extrapyramidal and autonomic nervous signs. Subjects were 48 MSA patients: 23 with VCP and age- and illness duration-matched 25 without VCP. MSA in this paper comprised clinically Shy-Drager syndrome, olivopontocerebellar atrophy, and striatonigral degeneration. MSA patients with VCP had in general more severe neurological findings, compared with those without VCP. Urinary incontinence developed in the relatively early stage of illness and preceded VCP in all patients. VCP developed not only in far-advanced stage but at any time in the course of illness. As to swallowing function when a diagnosis of VCP was established, about half of the patients with VCP needed nasogastric tube feeding and the remaining half tolerated oral feeding. VCP correlated strongly with urinary incontinence but not always with the severity of orthostatic hypotension or extrapyramidal tract sign such as parkinsonism. Five of the eight patients without tracheostomy came to sudden death. The mean duration from making a diagnosis of VCP to death was 1.1 years. In contrast, nine of the 11 patients with tracheostomy were alive and the survival periods after tracheostomy reached a maximum, five years. These facts suggest that the prognosis for life in the patients with VCP depends in part upon whether tracheostomy was carried out or not.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1990

[High-field MR findings of multiple system atrophy].

Magnetic resonance images obtained at 1.5T were reviewed in 23 patients with clinically diagnosed multiple system atrophy (MSA). The patient group consisted of 13 cases with olivoponto-cerebellar atrophy (OPCA), three with striatonigral degeneration (SND), and seven with Shy-Drager syndrome (SDS). In each disorder group, hypointensity of the pars compacta of the substantia nigra was frequently demonstrated as well as the atrophy of the brain stem and cerebellum. Although T2-weighted images depicted hypointensity of the putamen, which was prominent in its posterolateral part, in cases with SND and SDS, it was not encountered in cases with OPCA. Therefore, this finding was considered to facilitate differential diagnosis between OPCA and other two disorders. These hypointensities in the putamen and pars compacta of the substantia nigra may be due to excessive iron deposition and seem to correlate with extrapyramidal tract signs of MSA.

Corpus Striatum↗
PubMed1989

[Virus-induced subacute spongiform encephalopathy (Creutzfeldt-Jakob disease): a report of 10 cases with clinico-pathologic study].

This article is a report of clinico-pathological study of 10 cases, including 6 cases from Western Australia and 4 cases from Beijing and Qingdao of China. In all the 10 patients there were typical clinical features. Prodromal duration varied from 1.5 to 3 months and the dementia duration from 1 to 9.5 months. The clinical manifestations consisted of rapidly progressive dementia, myoclonic jerks. Pyramidal, extrapyramidal tract signs and cerebellar signs and periodic EEG findings. Neuropathological changes of this disease were spongiform changes, neuronal degeneration and loss of the ganglia cells and hypertrophy and hyperplasia of astrocytes. 2 of the 10 patients had brain biopsy and the other 8 had autopsy. Typical membrane bound vacuoles were shown under electron microscope. The frontal temporal and occipital lobes were more seriously affected than the parietal lobe and particularly the pre and postcentral gyri. The small and medial size ganglion cells were more seriously involved than large neuronal cells. Pyramidal cells were only mildly. In cases with a short duration, (less than 5 mouths), the spongiform changes were marked, but in those with a longer duration more than 6 months, they were mild. Neuronal loss and hypertrophy and hyperplasia of the astrocytes were mild in cases with short duration but were marked in those with longer duration. The clinical diagnosis, EEG findings, neuropathological features etiology and prognosis of this disease are discussed.

Adult↗
PubMed1987

[Dementia and disturbance of consciousness in thalamic degeneration].

A 53-year-old male with thalamic degeneration is presented. He had double vision, cerebellar signs, and pyramidal and extrapyramidal tracts signs in addition to hypersomnia, decrease in spontaneity and attention, and impairment of memory as psychic symptoms. These signs and symptoms were progressive, and he subsequently developed akinetic mutism and died of pneumonia 17 months after the onset of the disease. His clinical diagnosis was considered as Gerstmann-Sträussler syndrome due to progressive dementia, cerebellar signs and the other signs mentioned above. The postmortem pathological investigations, however, revealed thalamic degeneration. The pathological observations showed marked loss of nerve cells and glial proliferation in the medial and anterior nuclei of thalamus. The same pathological changes were more or less demonstrated in the pulvinar, the periaqueductal gray matter of midbrain, inferior olivary nucleus, the medial parts of globus pallidus, the substantia nigra and the dentate nucleus. In the early stage of the clinical course, it was difficult to know whether the main symptoms were caused by dementia or by the disturbance of consciousness. Retrospective considerations, however, showed that dementia had appeared at first, and subsequently the disturbance of consciousness had joined. As the result, it seems that they finally caused akinetic mutism. It is known as thalamic dementia that in the cerebrovascular disease the lesions in the medial and anterior parts of bilateral non-specific thalamic nuclei cause dementia.(ABSTRACT TRUNCATED AT 250 WORDS)

Brain Stem↗
PubMedDate not supplied

Familial Creutzfeldt-Jakob disease: three autopsy cases of the panencephalopathic type.

Three autopsy cases of panencephalopathic type of familial Creutzfeldt-Jakob disease (CJD) were investigated. Cases 1 (51-year-old male) and 3 (54-year-old female) were siblings and Case 2 (68-year-old female) was their aunt. In cases 1 and 3, the age of onset (Case 1:51, Case 3:53), duration of illness (Case 1:9 months, Case 3:8 months) and neuropsychiatric symptoms (pyramidal and extrapyramidal tracts involvements, blindness and dementia in chronological order) were similar, but in Case 2, the onset was later (66 years old), duration was longer (32 months) and the initial symptom was dementia. Myoclonus and apallic state in the terminal stage were common to all 3 cases. Neuropathologically, all 3 cases had characteristics that indicated panencephalopathic type of CJD. Cases 1 and 3 had similar neuropathological findings with characteristic circumscribed necrotic foci in the subcortical white matter. In Case 2 in contrast, diffuse demyelination and fibrillary gliosis in the cerebral white matter were observed without circumscribed necrotic foci. In the cerebellum of Case 3, granular cell loss was very slight. The other lesions in the cerebral cortex and striatum of the 3 cases were common. In conclusion, the clinical symptoms and neuropathological findings of our familial CJD cases were different from one another.

Aged↗
PubMed1995

First clinical experience with olanzapine (LY 170053): results of an open-label safety and dose-ranging study in patients with schizophrenia.

Although neuroleptic drugs have proven value in the management of patients with schizophrenia, the existing drugs are far from ideal. The pharmacological profile of olanzapine (LY 170053, Lilly) in animal models suggests that it may be an effective antipsychotic drug in humans, with the potential for a reduced incidence of desirable extra-pyramidal side effects, compared to existing neuroleptics. The results of this first investigation of olanzapine in schizophrenic patients indicate that it has efficacy as an antipsychotic compound, relieving positive and negative features of schizophrenia. Olanzapine appears to have an acceptable degree of overall tolerability, and may be associated with a low incidence of extrapyramidal tract symptoms. It does not appear to be free of adverse effects on liver function.

Adolescent↗
PubMed1996

[Hypothermia and the nervous system. Review of the literature apropos of 4 cases].

Thermoregulation involves a long term adaptation system with hormonal processes and an immediate regulation system by extrapyramidal tracts, sympathetic part of autonomic nervous system and cortical integration of body temperature changes. Both system are under control of a hypothalamic center. Prolonged accidental exposure to intense cold and myxoedematous coma are the best known etiologies of hypothermia. However milder and often misdiagnosed hypothermia can occur at home in patients without endocrinologic disease. In these cases, hypothermia is due to dysfunction of immediate thermregulation under neuronal control, especially somatomotor and autonomic system. We report four cases of hypothermia of this kind. Two patients had an inhibition of peripherical mechanisms of protecting against cold (cutaneous vasoconstriction, shivering) and had dampened perception of cold: one was 73, had diabetes mellitus and took different drugs, the other one suffered from systemic lupus with myelopathy. The two other patients probably had a disorder of the thermoregulation hypothalamic center: one had Wernicke's encephalopathy and the other multiple sclerosis. From these cases and a review of the literature, we describe the different etiologies of hypothermia and their pathophysiology.

Adult↗