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Basal Ganglia
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Basal Ganglia Anatomical Review
Basal Ganglia Anatomical Grouping
Basal Ganglia Anatomical Grouping
Basal Ganglia
Basal Ganglia Direct and Indirect Pathways
Basal Ganglia Loops
Figure 1
The Lancet 2014 384, 523-531DOI: (10.1016/S0140-6736(13)62418-6) Copyright © 2014 Elsevier Ltd Terms and Conditions
Basal Ganglia Loops
Basal Ganglia Somatotopic Organization
7 Concepts for The Rate Model
Basal Ganglia Indirect Pathway
Motor Tic Disorder
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Sydenham’s Chorea
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Hemichorea--Hemiballism after Diabetic Ketoacidosis
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Basal Ganglia Direct Pathway
Figure 3
The Lancet 2014 384, 523-531DOI: (10.1016/S0140-6736(13)62418-6) Copyright © 2014 Elsevier Ltd Terms and Conditions
Young Onset Parkinson’s Disease
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Parkinson’s Feature of Re-Emergent Tremor
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Video Examples
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Unified Parkinson’s Disease Ra%ng Scale
• Hand Movements • O = Normal • 1 = mild slowing, and/or reduc,on in amplitude • 2 = moderately impaired, definite and early fa,guing, may have occasional arrests
• 3 = severely impaired, frequent hesita,ons and arrest • 4 = can barely perform
Basal Ganglia Hyperdirect Pathway
Neurodegenerative Diseases of the Basal Ganglia
Lewy body disease in Parkinson’s
Lewy body disease in Parkinson’s
Parkinson disease, Lewy body: The Lewy body is the pathological hallmark of Parkinson disease. The Lewy body inclusion shows an eosinophilic core surrounded by a pale halo (arrow). The protein alpha-‐synuclein is a component of the Lewy body.
Degenerative Substantia Nigra in Parkinson’s Disease
The lea shows Parkinson's disease with a pale substan,a nigra compared to a normal ,ssue on the right
Genetic Neurodegenerative Disorder – Hunington’s Disease
Microscopically, the caudate nucleus in Hun,ngton's disease demonstrates loss of neurons along with gliosis.
Hun,ngton's disease is shown grossly in this coronal sec,on of the brain. It demonstrates atrophy of the caudate with resultant increase in size of lateral ventricles.
Lacunar Infarction of the Basal Ganglia
Lacunar infarct (<1cm): A rela,vely small cys,c lesion in the putamen secondary to small vessel disease. Common loca,ons for lacunes include basal ganglia, pons, internal capsule, thalamus and cerebral white maSer.
Lacunar Infarcts
Mechanisms that Injure the Basal Ganglia
Poewe W, Djamshidian-‐Tehrani A. Movement disorders in systemic diseases. Neurol Clin. 2015 Feb;33(1):269-‐97.
Poewe W, Djamshidian-‐Tehrani A. Movement disorders in systemic diseases. Neurol Clin. 2015 Feb;33(1):269-‐97.
Poewe W, Djamshidian-‐Tehrani A. Movement disorders in systemic diseases. Neurol Clin. 2015 Feb;33(1):269-‐97.
Carbon monoxide poisoning: During the first few hours aaer carbon monoxide poisoning, the brain is swollen, congested and cherry-‐red. Aaer 24-‐48 hours of survival, scaSered petechial hemorrhages may be seen in white maSer with larger hemorrhages in the pallidum (arrows).
Pesticide Induced Destruction of Basal Ganglia
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Infectious Destruction of Basal Ganglia
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Immune Cross-Reactivity of the Basal Ganglia – PANDAS
(Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus)
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Iron Accumulation Induced Destruction of the Basal Ganglia
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Globus Pallidus Iron Accumulation
Copper Toxicity (Wilson’s Disease) Destruction of the Basal Ganglia
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Wilson disease (hepatolen%cular degenera%on): Wilson disease is an autosomal recessive disorder caused by muta,ons in a copper transport gene (ATP7B). The putamen appears brown and shrunken. The caudate is oaen severely affected, but pallidum, thalamus and brain stem may be less severely involved.
Autoimmune Destruction of Basal Ganglia
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Basal Ganglia and Nutritional Considerations