is a
Movement disorder characterised by unilateral wild, large
Amplitude flinging movements of the arm and leg, normally causing falls and preventing postural maintenance.
It is caused by a
Lesion or
Infarction in the contralateral
Subthalamic Nucleus or its connections, usually in patients with a
History of
Hypertension or
Diabetes , or following
TB Meningitis . The subthalamic nucleus normally regulates the
Globus Pallidus by exciting the GPi, which in turn normally inhibits the
Ventral Lateral Nucleus of the
Thalamus . The reduced discharge in both causes disinhibition of the thalamus and consequent involuntary stimulation of the motor cortex. Altered dopaminergic feedback mechanisms may also be involved.
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Chemical treatment is via
Dopamine blockade, or via surgical lesions to the globus pallidus, lenticular fasciculus or VL nucleus of thalamus.
