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Parkinsonism and other extrapyramidal diseases 

Parkinsonism and other extrapyramidal diseases
Chapter:
Parkinsonism and other extrapyramidal diseases
Author(s):

Elisaveta Sokolov

, Vinod K. Metta

, and K. Ray Chaudhuri

DOI:
10.1093/med/9780198746690.003.0585
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date: 25 February 2021

The human basal ganglia is a complex functional organization, with important interconnections with the nigrostriatal pathway, which dominates the dopaminergic innervation of the striatum (caudate nucleus and the putamen). The principal clinical syndromes affecting it are Parkinson’s disease; other syndromes with parkinsonian features (including drug-induced parkinsonism); progressive supranuclear palsy; multisystem atrophy; dementia with Lewy bodies; neuroacanthosis; torsion dystonia; and chorea. Apart from the use of dopaminergic agents, several drugs have beneficial effects in the management of parkinsonism and other extrapyramidal diseases. Parkinson’s disease affects about 0.2% of the population, including 2% of those over 80 years of age. The main pathological feature is degeneration of neuromelanin-containing neurons and Lewy body inclusions in the pars compacta of the substantia nigra, which leads directly and indirectly to excessive inhibition of the thalamus and consequent bradykinesia.

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