Basal ganglia dysfunction

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

  • Alternative Names
    • Extrapyramidal syndrome; Antipsychotics - extrapyramidal

  • Causes
    • Athetosis resulting from basal ganglia injury

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

      • Carbon monoxide poisoning
      • Drug overdose
      • Head injury
      • Infection
      • Liver disease
      • Metabolic problems
      • Multiple sclerosis (MS)
      • Poisoning with copper, manganese, or other heavy metals
      • Stroke
      • Tumors

      A common cause of these findings is chronic use of medicines used to treat schizophrenia.

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

  • Symptoms
    • Damage to the basal ganglia cells may cause problems controlling speech, movement, and posture. This combination of symptoms is called parkinsonism.

      A person with basal ganglia dysfunction may have difficulty starting, stopping, or sustaining movement. Depending on which area of the brain 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 or slowed movements
      • Increased muscle tone
      • Muscle spasms and muscle rigidity
      • Problems finding words
      • Tremor
      • Uncontrollable, repeated movements, speech, or cries (tics)
      • Walking difficulty
  • Exams and Tests
    • The health care provider will perform a physical exam and ask about the symptoms and medical history.

      Blood and imaging tests may be needed. These may include:

      • CT and MRI of the head
      • Genetic testing
      • 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.

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

  • When to Contact a Medical Professional
    • Call your provider if you have any abnormal or involuntary movements, falls without known reason, or if you or others notice that you are shaky or slow.

  • References
    • Jankovic J. Parkinson disease and other movement disorders. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 96.

      Lang AE. Other movement disorders. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 410.

      Melnick ME. Basal ganglia disorders. In: Umphred DA, Burton GU, Lazaro RT, Roller ML, eds. Umphred's Neurological Renabilitation. 6th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 20.