Escolar Documentos
Profissional Documentos
Cultura Documentos
Djadjang Suhana
Department of Neurology
Medical Faculty Padjadjaran University
Bandung
BALLISM
ABRUPT ONSET OF VIOLENT
FLINGING MOVEMENTS.
AFFECTING THE LIMBS, NECK, TRUNK
OFTEN ON ONE SIDE OF THE BODY
HEMIBALLISM
A SINGLE LIMB MONOBALLISM
DUE TO A LESION INVOLVING THE
SUBTHALAMIC NUCLEUS
DYSTONIA
• THE MOVEMENT ATHETHOSIS
MOVEMENT
• USUALLY CONTORTION MOVEMENT OF
THE TRUNK, LIMBS, HEAD AND NECK.
• THE SITE OF LESION: CORPUS STRATUM
AND GLOBUS PALLIDUS
DEGENERATIVE DISEASE
INTRODUCTION.
• PROGRESSIVE
• SELECTIVE
• GENETIC AND FAMILIAL
• PATHOMECHANISM IS UNKNOWN
PATOLOGY.
LOSS OF INSIGHT
APATHY, AGITATION, AGGRESSION
IRRITABILITY, EUPHORIA,
DEPRESSION
COMBINATION.
FOCAL SIGNS :
DYSPHASIA
DYSCALCULI
DYSLEXIA
DYSGRAPHIA
DYSPRAXIA
GAIT APRAXIA (PARKINSONIM)
PHYSICAL EXAMINATION
MENTAL EXAMINATION :
• MMSE (MINI-MENTAL SCORE
EXAMINATION)
MOTORIC EXAMINATION :
• NORMAL
DEGENERATIVE REFLEX :
• SNOUT
• PALMOMENTAL
• GRASP
INCREASE OF PHYSIOLOGIC REFLEXES
PATHOLOGIC REFLEXES ARE POSITIVE
SPARING
CRANIAL AND PERIPHERAL NERVES
CEREBELLUM
LOCOMOTION
SENSIBILITY
• NORMAL
DIAGNOSTIC PROCEDURES.
EEG
CT-SCAN
AMYOTROPHIC LATERAL SCLEROSIS
(MOTOR NEURON DISEASE)
CHRONIC DISEASE
PROGRESSIVE DEGENERATION OF
MOTOR NEURONS OF:
•THE ANTERIOR HORN OF THE SPINAL
CORD
•MOTOR NUCLEI IN BRAIN STEM
•MOTOR NEURONS IN CEREBRAL
CORTEX
THE ETIOLOGY IS UNKNOWN, MAY BE
CAUSE BY METAL INTOXICATION OR
VIRAL INFECTION
TYPES OF ALS.
1. PROGRESSIVE MUSCULAR ATROPHY
NEURONAL LOSS IN THE ANTERIOR
HORN OF SPINAL CORD
FIRSTLY IN CERVICAL REGION
CORTICOSPINAL AND SENSORY TRACT ARE
INTACK.
CLINICAL FINDING:
PARESIS
FASCICULATION MOVEMENTS.
TYPES OF ALS (CONT.)
• RIGIDITY
• TGREMOR
• BRADYKINESIA
PARKINSONM (CONT.)
CLINICAL CATEGORIES :
1. PARALYSIS AGITANT (IDIOPATHIC
PRAKINSONM)
2. POSTENCEPHALYTIC PARKINSONISM
3. ARTERIOSCLEROSIS PARKINSONISM
4. DRUG-INDUCED PARKINSONISM
5. PARKINSONM DUE TO INFECTION
6. TOXIC PARKINSONISM
7. ANOXIC ENCEPHALOPATHY
PARKINSONISM
8. PARKINSONISM IN ALZHEIMER DISEASE
THE ETIOLOGY IS DECREASE OF
DOPAMIN ACTIVITY.
• POSTURAL HYPOTENSION
• DEPRESSION
• DEMENTIA
HUNTINGTON’S DISEASE
(HUNTINGTON CHOREA)
• HEREDITARY DEGENERATIVE
• CHOREOATHETOSIS AND DEMENTIA
• CHROMOSOME-4 DISORDER
• CORTICAL ATROPHY, ESPECIALLY IN
FRONTAL LOBE
• VENTRICEL DILATATION
• NEURONAL LOSS, REACTIVITY OF GLIAL
CELL (ASTROCYTES)
• DEFCIENCY OF GABA, ACETHYLCHOLINE,
SUBSTANCE-P, DYNOPHINE.