extrapyramidaalisia

Extrapyramidal symptoms are a group of neurological symptoms that are not directly related to the pyramidal system, which is responsible for voluntary movement. These symptoms are often associated with the use of certain medications, particularly dopamine agonists and antipsychotics, and can also occur in conditions such as Parkinson's disease and stroke. Extrapyramidal symptoms can manifest as either positive or negative symptoms.

Positive extrapyramidal symptoms include involuntary movements such as dystonia, akathisia, and choreiform movements. Dystonia is characterized by sustained muscle contractions that cause twisting and repetitive movements, often in the face, neck, or limbs. Akathisia is a state of restlessness and an urge to move, which can be accompanied by feelings of tension and anxiety. Choreiform movements are rapid, jerky, and often purposeless movements that can affect the entire body or specific limbs.

Negative extrapyramidal symptoms, on the other hand, involve a decrease or absence of normal movement. These symptoms can include bradykinesia, which is a slowing of movement, and hypokinesia, which is a reduction in the range of movement. Rigidity is another negative symptom, characterized by increased muscle tone and resistance to passive movement. Tremor, although typically associated with the basal ganglia, can also be an extrapyramidal symptom and is characterized by rhythmic oscillations of a body part.

The exact mechanisms underlying extrapyramidal symptoms are not fully understood, but they are believed to involve the dopamine system and the basal ganglia. Dopamine agonists, which are used to treat Parkinson's disease, can exacerbate extrapyramidal symptoms, while dopamine antagonists, such as antipsychotics, can alleviate them. The management of extrapyramidal symptoms often involves the use of anticholinergics, which block the action of acetylcholine, a neurotransmitter that can exacerbate these symptoms. In severe cases, the use of dopamine antagonists may be necessary to control the symptoms.