Motor dysfunction

Introduction Movement disorders, also known as extrapyramidal diseases, mainly manifest as voluntary motor regulation dysfunction, muscle strength, sensory and cerebellar function are not affected. The regulation of motor function can be accomplished by the close cooperation of the pyramidal system, basal ganglia and cerebellum. These three are not independent and independent systems, but are functionally an inseparable whole. Dyskine disorders (ie, extrapyramidal diseases) are mainly caused by basal ganglia dysfunction.

Cause

(1) Causes of the disease:

The regulation of motor function can be accomplished by the close cooperation of the pyramidal system, basal ganglia and cerebellum. These three are not independent and independent systems, but are functionally an inseparable whole. Dyskine disorders (ie, extrapyramidal diseases) are mainly caused by basal ganglia dysfunction.

(2) Pathogenesis:

The basal ganglia has complex fiber connections and mainly constitutes three important neural circuits: 1 cortical-cortical loop: cerebral cortex - caudate putamen - medial globus pallidus - thalamus - cerebral cortex; 2 substantia nigra-striatum loop : black matter and caudate nucleus, caudal nucleus between the fibers; 3 striatum - globus globule loop: caudate nucleus, caudate nucleus - lateral globus pallidus - subthalamic nucleus - medial globus pallidus.

There is a direct pathway in the cortical-cortical loop (striatum-medial globus pallidus/black matter reticular) and indirect pathway (striatum-lateral globus pallidus-thalamic nucleus-medial globus pallidus/black matter reticular The loop is the anatomical basis for the basal nucleus to achieve motor regulation. The balance of activity between the two pathways is critical to achieving normal motor function.

an examination

Related inspection

Motor function test for bone and joint soft tissue CT examination of anti-leaching nuclear antigen (ENA) antibody

Blood electrolytes, trace elements and biochemical tests are helpful for the diagnosis of dyskinesia diseases, such as serum copper, urinary copper and serum ceruloplasmin in patients with Wilson's disease, which has important diagnostic significance.

1. CT or MRI examination: such as hepatolenticular degeneration, can show bilateral low density lesions in the lenticular nucleus or MRI display signal abnormalities.

2. Positron emission tomography (PET) or single photon emission tomography (SPECT): can show the reduction of striatum DA transporter (DAT) function, decreased DA transmitter synthesis and D2 type DA receptor activity, etc. The diagnosis of Parkinson's disease is quite meaningful.

3. Genetic analysis: It is of great significance for the diagnosis of certain hereditary dyskinesia diseases.

Differential diagnosis

Biliary dysfunction: including dysfunction of biliary tract (dyskinesis), abnormal biliary tone (dystonia), and ataxic (ataxic). The disease is more common in women, its clinical manifestations and gallstones are very similar, mainly for abdominal pain, paroxysmal cramps in the upper abdomen or right upper abdomen, some patients may be accompanied by nausea and vomiting, may be induced by eating greasy food, often lasting 2 ~3h, the symptoms are relieved after the antispasmodic drug.

Glottic dyskinesia: It is a type of disorder in which the glottic motor function is abnormal due to various causes and the clinical manifestation is vocal dysfunction. Can be divided into neurological, muscular, joint and functional. First, laryngeal glottic dyskinesia: laryngoscopy: light can be seen in the vocal cords bow, heavy vocal activity is slow or inactive, and can not even cough.

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