Atetoz

atetoz fingersAtetoz - involuntary continuous worm-like movements of the fingers, toes, rarely persons (faces), torso. Is a form of hyperkinesia.
Atetoz occurs when the defeat of the basal ganglia of the brain (often striped body), it happens when the encephalitis, birth trauma, some hereditary nervous diseases. Fingers when acetose slowly bent, unbend, are discharged and are taking pretentious position (Fig). Increase of a tone of muscles at acetose together with a decrease. Atetoz enhanced by active movements, unrest, weakened during sleep. Treatment of the underlying disease, exercise therapy, anticonvulsants, sometimes surgery subcortical knots brain, and the creation of immobility in the joints (fusion).

Atetoz (from the Greek. athetos is devoid of a certain provisions unstable)- hyperkinesia, which is expressed slow tonic spasm, exciting at the same time the muscles agonists and antagonists. The degree of the tonic spasm variable and is prevalent in some, other muscle groups, which causes pretentious forced movements slow, worm-like, as if floating in the muscles. Muscle tone when acetose characterized by variability and lability, severe hypertension replaced hypotension, then it comes again hypertension and so on Variability of muscle tone when acetone is called rolling spasm (spasmus mobilis). Atlasniy hyperkinesis expressed mostly in the muscles of the face and distal extremities, especially the hands, often in the muscles of the body. The fingers are no particular order bend and unbend; when one finger maximum unbent, other maximum bend, discharged and given, the brush is bizarre poses. Typical peremeshivanie terminal phalanges. Atetoz often expressed only in one part of the body - galiatatos. Hyperkinesis in speech muscles causes serious speech disorders. In a state of mental and physical rest atetoz decreases in the dream disappears. Various irritation, especially emotions and active movement, strengthen atlasniy hyperkinesis. Atetoz appears when different processes - inflammatory, traumatic and others that affect basal ganglia, especially striped body. Most often, A. occurs when encephalopathy and encephalitis in children. A. can occur not only as a symptom, but also as a form of the disease (double atetoz)., Cm. also, Giperkineza.
Double atetoz (athetose double) develops when abnormal changes in subcortical knots. These changes (the so-called status marmoratus) may be an anomaly of development and the result of various processes, developing in immature neostriatum. Some authors attach great importance to birth trauma. In some cases dual A. occurs in RH conflict. History of patients with dual A. often there are indications premature and difficult birth, but the fate of the sick any pathology in history is not checked.
Pathological anatomy. In the field of the caudate nucleus (nucl. caudatus) and shell (putamen) macroscopically significantly disorderly increase myelinated fibers, which makes these formations kind of "marble". Defeat in typical cases expressed symmetrically. Microscopically at colouring on the myelin seen a significant increase in thin makalnyh fibres, at colouring of silver on Belovskom - increasing nerve fibrils. Grows also fibrous and plasma glia. The number of ganglion cells in the striatum reduced, and in areas of proliferation of fiber cells fall.
Symptoms usually occur from the first days and are especially apparent by the end of the first year of life, when healthy child should sit, stand and begin to walk and talk. They are expressed violent movements and variability tone. Hyperkinesis most strongly expressed in the muscles of the face, hands, and toes. Violations of tone and hyperkinesia in the face and voice muscles causes serious speech disorders. Sick children start to speak very late; it's dizartria, in more severe cases, quite incomprehensible. Muscle tone hands volatile, foot - often dramatically increased, more in the extensor. Tendon reflexes, as a rule, live, sometimes increased, but symptoms pyramid defeat is not observed. The big toe is in a constant state of extensii that is regarded as psevdonimom Babinsky. All kinds of sensitivity saved, sphincter function normally. Some patients developing seizures, sometimes immediately after birth. Intelligence can be reduced to varying degrees, but most of the decrease is observed in the presence of seizures. Possible complete safety of mental functions and good development of the intellect. Double atetoz not progressing. Physical and mental functions of the child very slowly and gradually develop, it acquires some motor skills, his mental development progresses.
Treatment. Because double atetoz is the result of the already completed processes, rather effective methods of treatment there. However, systematic physiotherapy exercises, the use of artena, trapezina, vitamin B6, galantamina give positive results. Arten (trihexyphenidyl) designate tablets 0,001-0,002 g, tropatsin - 0,01 - 0,015 g 1-2 times a day; vitamin B6 is used per os (0.01-0.025 g 2-3 times a day) or intramuscularly (1 ml of 2.5% solution of 1 per day); galantamine is injected subcutaneously to 1 ml of 0.25-1% solution of 1 per day. Children dose all drugs is reduced accordingly. At insufficiency of mental development, it is recommended long-purpose glutamic acid, when epileptic seizures - anticonvulsants. Systematic studies with a sick child. Many children respond well to training, some even have revealed great ability in any field of knowledge. When a saved possible intelligence operative treatment of double acetosa using stereotactic apparatus.