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Aside from the well known motor system of pyramidal nerve fibers, there is another system of motor fibers known as extrapyramidal. The structures making up the extrapyramidal system have not as yet been agreed on. Lotmar accepts Spatz' classification—the corpus striatum (putamen + nucleus caudatus), globus pallidus, nucleus ruber, corpus subthalamicum (nucleus of Luys), substantia nigra and nucleus dentatus cerebelli. Lesions of any of these structures alone or combined are supposed to be responsible for a great variety of clinical entities characterized by motor restlessness (hyperkinetic movements), rigidity and changes in the tonicity of the muscles. In some instances cortical changes participate, for instance, in Huntington's chorea, while in others, such as athetosis, torsion spasm, certain forms of torticollis and chorea, Wilson's disease and paralysis agitans, only the basal ganglions are implicated. Postencephalitic states have contributed an enormous amount of clinicopathologic facts which unfortunately have obscured rather than helped the understanding
Die Stammganglien und die extrapyramidal-motorischen Syndrome.. JAMA. 1926;87(19):1581. doi:10.1001/jama.1926.02680190057037
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