Basal ganglia dysfunction

Definition

Basal ganglia dysfunction is a problem with the basal ganglia, the deep brain structures that help start and control movement.

Alternative Names

Extra-pyramidal syndrome

Causes, incidence, and risk factors

Conditions that cause injury to the brain can damage the basal ganglia. Such conditions include:

• Drug overdose
• Head injury
• Infection
• Liver disease
• Metabolic problems
• Multiple sclerosis
• Side effects of certain medications
• Stroke
• Tumors

Many brain disorders are associated with basal ganglia dysfunction. They include:

• Dystonia
• Huntington's disease
• Multiple system atrophy
• Parkinson's disease
• Progressive supranuclear palsy
• Wilson's disease

This list may not be all-inclusive.

Symptoms

Damage to the basal ganglia cells may cause problems with one's ability to control speech, movement, and posture. A person with basal ganglia dysfunction may have difficulty starting, stopping, or sustaining movement. Depending on which area is affected, there may also be problems with memory and other thought processes.

In general, symptoms vary and may include:

• Movement changes, such as:
  • Involuntary movements
  • Slowed movements
• Increased muscle tone
• Muscle spasms and muscle rigidity
• Memory loss
• Problems finding words
• Tremor
• Uncontrollable, repeated movements, speech, or cries (tics)
• Walking difficulty

Signs and tests

The health care provider will perform a complete physical and neurological exam. Depending on the results, blood tests and imaging studies of the brain may be needed. This may include:

• CT and MRI of the head
• Magnetic resonance angiography to look at the blood vessels in the neck and brain
• Positron emission tomography (PET) to look at the metabolism of the brain
• Blood tests to check blood sugar, thyroid function, liver function, and iron and copper levels

Treatment

Treatment depends on the cause of the disorder.

Support Groups

Expectations (prognosis)

How well a person does depends on the cause of the dysfunction. Some causes are reversible, while others require lifelong treatment.

Complications

Calling your health care provider

Call your health care provider if you have any abnormal or involuntary movements, unexplainable falls, or if you or others notice that you are shaky or slow.

Prevention

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References

Lang A. Parkinsonism. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 433.

Lang A. Other movement disorders. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 434.