throwing
Introduction
Introduction to throwing sports Throwing movement (ballism) is the damage of the subthalamic nucleus or the associated path, which leads to the involuntary movement of the limb throwing, and involves one side of the body, so it is also called the side-throwing movement (hemiballism). Expressed as a strong involuntary limb, waving a dance-like movement. Bilateral throwing exercises involve both limbs, but are rare in clinical practice. basic knowledge The proportion of sickness: 0.01% Susceptible people: no specific population Mode of infection: non-infectious Complications: swelling
Cause
Throwing motion cause
(1) Causes of the disease
1. The most common cause of unilateral throwing disease is hemorrhagic and ischemic cerebrovascular disease, such as infarction or hemorrhage in the internal capsule area. Patients often have cerebrovascular disease susceptibility factors such as diabetes, and some patients have CT or MRI examination. Nuclear cavity-like state.
2. Intracranial infections include various acute and chronic encephalitis, such as herpes simplex encephalitis, prion infection (Creutzfeldt-Jakob disease), etc. Recently, it has been reported that cerebral cryptococcal infection in AIDS patients may cause unilateral throwing; Immune diseases such as systemic lupus erythematosus, rheumatism and other intracranial complications.
3. Some are extrapyramidal diseases, such as chorea, hepatolenticular degeneration, etc., and clinical manifestations of hemian heading may occur.
4. Brain tumors, brain trauma, antipsychotic haloperidol, etc., cause delayed dyskinesia, etc. may also be associated with throwing disease.
(two) pathogenesis
Most patients with unilateral throwing disease are caused by hemorrhage due to inversion of the subthalamic nucleus and its efferent bundle, which can be caused by infection, metastatic tumor and demyelinating disease.
The consequence of damage to the subthalamic nucleus is to attenuate normal tension excitatory effects, reduce the inhibitory output (GABA) of the globus pallidus and substantia nigra to the thalamus, and the thalamus to export more excitatory transmitters to the cerebral cortex. Amino acid, which causes the symptoms of this disease, because such drugs reduce the inhibitory effect of the striatum on the medial globus pallidus and the substantia nigra reticular, so glutamate or dopamine antagonists can treat the disease.
Prevention
Throwing prevention
Mainly to prevent the primary disease that may cause ballism, while paying attention to strengthen the patient's life care and prevent various complications.
Complication
Throwing sports complications Complications swelling
Most of the unilateral throwing disease is caused by the inferior mass of the subthalamic nucleus and its efferent bundle, which can be caused by infection, metastatic tumor and demyelinating disease. Therefore, there is a corresponding clinical manifestation of the primary disease.
Symptom
Throwing sports symptoms common symptoms throwing action (twitching) wrist swelling tenderness local tenderness
1. Usually the onset is sudden, and a few can also gradually develop within a few weeks.
2. The clinical manifestations are powerful, coarse, and variable in form, rapid and purposeless throwing movement, which is common in the face, neck, trunk and limbs. The unilateral throwing disease involves one side of the upper and lower limbs, but only limited to one limb. Limb throwing, limb throwing movement by the proximal muscle and the distal muscle combined action, the finger can also be affected.
3. Appear only in the state of awakening, aggravation during emotional excitement, stop during sleep, patients often retain a certain degree of random control of abnormal exercise ability, can perform simple actions, but a random control time is only a moment, can not last.
Examine
Throwing movement check
Laboratory tests have no specificity, blood routine, erythrocyte sedimentation rate, C-reactive protein, biochemistry, routine examination of cerebrospinal fluid, and have differential diagnosis significance.
1. EEG examination may have abnormalities, but it is very mild. The incidence of EEG abnormalities is highest at the peak of the disease. After the clinical symptoms are recovered, the EEG is gradually recovered. This abnormal change is not specific.
2. Head CT, MRI examination has the cause and differential diagnosis significance.
Diagnosis
Throwing motion diagnosis
diagnosis
Throwing movement (ballism) is characterized by strong involuntary limbs, waving dance-like movements. According to its typical clinical symptoms, diagnosis is not difficult, but the diagnosis of primary disease leading to throwing movement needs to be based on different diagnostic criteria. determine.
Differential diagnosis
Must pay attention to the identification of other causes of chorea and similar symptoms:
1. Habitual sputum: Also known as habitual movement, more common in children, characterized by action stereotypes, limited to the same muscle or muscle group, no muscle strength, abnormal muscle tone and ataxia.
2. Congenital chorea: Dance-like movements can be used as a manifestation of cerebral palsy, mostly before the age of 2, often accompanied by mental retardation, tremors and spasticity.
3. Tourette's syndrome: Seen in children, rapid performance, stereotyped repeated irregular multiple muscle twitching, often involving the head and face, neck muscles and throat muscles, as well as strange or spit.
4. Huntington's disease: more common in middle-aged, in addition to dance movements, often with genetic history and dementia, a small number of childhood onset with muscle rigidity.
5. Twisting sputum: Common in childhood, sometimes twisting sputum movements can be mistaken for dance-like movements. Childhood torsion sputum often persists, without self-limiting, muscle tension increases when limbs are twisted, and stops when stopped.
