12. Extrapyramidal syndrome Flashcards
1
Q
Extrapyramidal system
A
Refers to basal ganglia and an array of brain stem nuclei
- Red nuclei, vestibular nuclei, sup. culliculus & reticular formation
- Regulates posture and skeletal muscle tone
2
Q
Characteristics
A
Specific changes in neurotransmitter profile (GABA, acetylcholine, glutamte, dopamine)
3
Q
Classifications
A
1) Akinetic-rigid syndromes: Poverty of move.
2) Dyskinesia: Excessive invol. move.
4
Q
Approach & diagnosis
A
Age of disease (onset; early-tourette syndrome, late-parkinson)
Past, drug & family
5
Q
Signs and symptoms
A
Autonomic symptoms: Dizziness, bladder complaints Alcohol responsive: Tremor Dystonia Akathisia (motor restlessness) Parkinsonism (e.g. rigidity) Bradykinesia Tremor Tardive dyskinesia
6
Q
Treatment
A
Anticholinergic drugs
- Control neuroleptic-induced EPS
- Benztropine, diphenhydramine, trihexyphenidyl
Dopamine agonist: Pramipexole
Akathisia: Beta blockers or benzodiazepines
Reduce dose of antipsychotic or switch to an atypical antipsychotic
- Ziprasidone, olanzapine, risperidone, or clozapine
7
Q
Causes
A
Antipsychotic that antagonize dopamine D2 rcpt - Haloperidol & fluphenazine Anti-dopaminergic drugs - Metoclopramide Antidepressants - SSRI, SNRI, NDRI
Brain damage, meningitis
