王学峰《神经病学精品教学》PD简化版-陈国俊.docVIP

重庆医科大学临床学院教案及讲稿 （教 案） 课程名称 Neurology 年级 授课专业 Neurology 教 师 陈国俊 职称 教授 授课方式 大课 学时 2 题目章节 Movement Disorders (80 min) 教材名称 Harrison’s Neurology in Clinical Medicine 作者 Stephen Hauser,etc. 出 版 社 McGraw Hill 版次 16th Edition(2006) 教 学 目 的 要 求 Anatomy of extrapyramidal system Major clinical features of movement disorders and representative diseases Causes and mechanisms of Parkinson’s Disease Principles in diagnosis and treatment of Parkinson’s Disease 教 学 难 点 Linking the pathophysiology to clinical features Drug choices and methods in the treatment of Parkinson’s Disease 教 学 重 点 Clinical features, diagnosis and treatment of Parkinson Disease 外语要求 English 教学方法手段 Multimedia with pictures 参考资料 神经病学（第二版），张淑琴主编 Neuroanatomy (3rd Edition), by James D. Fix Neurology in Clinical Practice (3rd Edition), by Water G. Bradley et, al. 教研室意见 教学组长： Yan, Yong 教研室主任：Wang, Xuefeng 2011年11 月12 日 （讲 稿） Movement Disorders Movement disorder are often considered as basal ganglia (BG) or extrapyramidal diseases. However, not all movement disorders are related to dysfunction of basal ganglia. Introduction to the basal Ganglia The basal ganglia consist of four groups of nuclei: the striatum (caudate nucleus and putamen) globus pallidus (or the pallidum), plus two related nulei, the subthalamic nucleus and the substantia nigra. Three pathways of extrapyramidal system: Cortex-cortex Substatia nigra-striatum Striatum-globus pallidus Major neurotransmitters Dopamine, acetylcholine, GABA, glutamate, and some neuropeptides such as ENK, Substance P. They work synchronically to maintain excitation and inhibitions of normal functions. Normal function of extrapyramidal system Regulates muscle tone Maintains posture Co-ordinates voluntary movement Common symptoms of movement disorders Hypertonia-decreased movement: parkinsonism Hypotonia- chorea, ballism Parkinson’s Disease（PD） PD, also called paralysis agita