Extrapyramidal Syndrome Definition, Reason, Symptoms, Treatment & Prevention
Definition
Extrapyramidal is a part of the brain that plays a role in automatic movements in everyday life. Examples are blinking your eyes or keeping your body upright.
Extrapyramidal syndrome (or often referred to as extrapyramidal symptoms) is a condition that occurs due to disturbances in the extrapyramidal system in the brain. As a result, sufferers make movements that are unconscious and difficult to control.
An extrapyramidal syndrome is generally caused by side effects of antipsychotic drugs. This drug is generally used to treat schizophrenia and several other types of mental disorders.
The symptoms of extrapyramidal syndrome vary widely. It can only be mild symptoms, but can also cause life-threatening conditions.
Extrapyramidal Syndrome Symptom
Extrapyramidal symptoms vary widely. In principle, extrapyramidal symptoms are uncontrollable movements of one part of the body or several parts of the body, which occur almost all the time. And these movements are usually not realized by the sufferer. Or in some cases, the movement is realized but cannot be controlled.
Symptoms that appear can be:
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Symptoms in the face and mouth area
Symptoms can include movements such as chewing, sticking the tongue in and out of the mouth, the tongue licking the cheek area, and mouth movements as if you are sucking on something. Sometimes, the face actually looks stiff, there is no movement at all, but the saliva keeps dripping from the corner of the mouth.
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Symptoms in the neck and spine
Sufferers often suddenly shake their head with a jerk (medically called torticollis). You can also nod and tilt your head alternately. This movement is painful. In the spine, symptoms that can occur are the back arching forward.
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Symptoms in the arms and legs
In the arms, uncontrollable movements can appear, such as wanting to punch or raising your hand repeatedly, as if you are going to ask a question. This movement can even occur when the sufferer is sleeping. In the legs, sufferers can continuously move their knees, or tap their feet on the floor. Walking in place, or placing body weight on one leg alternately can also occur.
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Symptoms on the vocal cords
Symptoms of the vocal cords cause the sufferer to make indistinct noises, such as yawning, clearing his throat, or his voice turning hoarse.
In addition to the above symptoms, extrapyramidal syndrome symptoms can also be life threatening. This severe condition is called neuroleptic malignant syndrome. There are four main symptoms of neuroleptic malignant syndrome, namely:
- Severe muscle stiffness
- Body temperature above 38 degrees Celsius
- Autonomic nervous instability such as excessive sweating, bed wetting, and so on
- Disturbed consciousness
Extrapyramidal Syndrome Reason
Under normal circumstances, the brain has several neurotransmitters (chemicals produced by the brain’s nerve endings). One of them is dopamine. Dopamine functions to control body movements.
Some types of antipsychotic drugs cause parts of the brain that are sensitive to dopamine to be disrupted. This is what triggers the occurrence of uncontrollable movements in extrapyramidal syndrome conditions.
In general, there are two types of antipsychotic drugs, namely:
- Older antipsychotic drugs (also known as typical antipsychotic drugs), such as chlorpromazine and haloperidol.
- New generation of antipsychotic drugs (also known as atypical antipsychotic drugs), such as risperidone, clozapine, olanzapine, and queitiine.
Older generation of antipsychotic drugs often causes extrapyramidal symptoms compared to newer generations.
Apart from the type of drug, there are several other conditions that make someone who takes antipsychotic drugs more susceptible to experiencing extrapyramidal symptoms. Among others are:
- Age 40 and over
- Taking antipsychotic drugs together with anti-seizure drugs, antihistamines, or antidepressants
- Have a brain disorder such as Parkinson’s or encephalitis
- Taking medication irregularly
Diagnosis
To ensure the existence of extrapyramidal syndrome, the doctor will conduct a complete interview about the patient’s complaints, as well as the antipsychotic drugs he is taking. Apart from that, the doctor will also make observations about the uncontrollable movements made by the patient.
Sometimes blood tests also need to be done to ensure that the patient’s complaints are not caused by other diseases.
Extrapyramidal Syndrome Treatment
The main thing that must be done in the treatment of extrapyramidal syndrome is to identify antipsychotic drugs that cause patient complaints. After that, the drug should be reduced slowly.
If the patient still needs antipsychotic drugs, the doctor will replace other antipsychotic drugs that have a lower risk of extrapyramidal syndrome. In addition, benzodiazepine, anticholinergic, or vitamin B6 drugs can also be given to help reduce symptoms.
If the extrapyramidal syndrome that occurs is a neuroleptic malignant syndrome, then treatment in the intensive care unit of the hospital must be carried out.
Prevention
If someone needs to take antipsychotic drugs, then the risk of extrapyramidal syndrome cannot be avoided. However, this risk can be reduced by taking antipsychotics according to the doctor’s instructions and routine control so that the dose of the drug can be adjusted as the patient’s medical condition changes.