Hypoxic-ischemic damage of the basal ganglia. Case reports and a review of the literature.
Three cases of movement disorders secondary to hypoxic-ischemic encephalopathy are reported. Despite similarities among the clinical events, the neurological syndromes produced were dissimilar. Cerebral hypoxia-ischemia typically produces lesions of the globus pallidus that may result in an akinetic rigid syndrome. Due to its unique blood supply, vascular insufficiency is found to be a major factor. Lesions in the putamen also occur, and these tend to be associated with dystonia. Recent evidence supports a specific neuronal sensitivity in the striatum, possibly due to afferent excitatory amino acid connections. These two components and changes in the levels of neurotransmitters during hypoxia-ischemia may interact to produce varied clinical outcomes. These factors must also be considered when planning therapeutic interventions.
Hawker
K
K
Toronto Western Hospital Movement Disorders Clinic, Ontario, Canada.
Lang
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D000328:Adult; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D002534:Hypoxia, Brain / Q000150:complications*; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed