The pyramidal tracts include both the
corticobulbar tract
In neuroanatomy, the corticobulbar (or corticonuclear) tract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata (also called ...
and the
corticospinal tract
The corticospinal tract is a white matter motor pathway starting at the cerebral cortex that terminates on lower motor neurons and interneurons in the spinal cord, controlling movements of the limbs and trunk. There are more than one million neur ...
. These are aggregations of
efferent nerve fiber
Efferent nerve fibers refer to axonal projections that ''exit'' a particular region; as opposed to afferent projections that ''arrive'' at the region. These terms have a slightly different meaning in the context of the peripheral nervous syste ...
s from the
upper motor neuron
Upper motor neurons (UMNs) is a term introduced by William Gowers in 1886. They are found in the cerebral cortex and brainstem and carry information down to activate interneurons and lower motor neurons, which in turn directly signal muscles t ...
s that travel from the
cerebral cortex
The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
and terminate either in the
brainstem
The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...
(''corticobulbar'') or
spinal cord
The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spi ...
(''corticospinal'') and are involved in the control of motor functions of the body.
The corticobulbar tract conducts
impulses from the
brain
A brain is an organ that serves as the center of the nervous system in all vertebrate and most invertebrate animals. It is located in the head, usually close to the sensory organs for senses such as vision. It is the most complex organ in a v ...
to the
cranial nerve
Cranial nerves are the nerves that emerge directly from the brain (including the brainstem), of which there are conventionally considered twelve pairs. Cranial nerves relay information between the brain and parts of the body, primarily to and ...
s. These nerves control the muscles of the face and neck and are involved in facial expression, mastication, swallowing, and other motor functions.
The
corticospinal tract
The corticospinal tract is a white matter motor pathway starting at the cerebral cortex that terminates on lower motor neurons and interneurons in the spinal cord, controlling movements of the limbs and trunk. There are more than one million neur ...
conducts impulses from the brain to the spinal cord. It is made up of a
lateral
Lateral is a geometric term of location which may refer to:
Healthcare
*Lateral (anatomy), an anatomical direction
* Lateral cricoarytenoid muscle
* Lateral release (surgery), a surgical procedure on the side of a kneecap
Phonetics
*Lateral co ...
and
anterior tract. The corticospinal tract is involved in voluntary movement. The majority of fibres of the corticospinal tract
cross over in the
medulla oblongata, resulting in muscles being controlled by the opposite side of the brain. The corticospinal tract contains the
axon
An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see spelling differences), is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as action po ...
s of the pyramidal cells, the largest of which are the
Betz cell
Betz cells (also known as pyramidal cells of Betz) are giant pyramidal cells (neurons) located within the fifth layer of the grey matter in the primary motor cortex. These neurons are the largest in the central nervous system, sometimes reaching ...
s, located in the cerebral cortex.
The pyramidal tracts are named because they pass through the
pyramids
A pyramid (from el, πυραμίς ') is a structure whose outer surfaces are triangular and converge to a single step at the top, making the shape roughly a pyramid in the geometric sense. The base of a pyramid can be trilateral, quadrilate ...
of the medulla oblongata. The corticospinal fibers converge to a point when descending from the
internal capsule
The internal capsule is a white matter structure situated in the inferomedial part of each cerebral hemisphere of the brain. It carries information past the basal ganglia, separating the caudate nucleus and the thalamus from the putamen and the ...
to the brain stem from multiple directions, giving the impression of an inverted pyramid. Involvement of the pyramidal tract at any level leads to
pyramidal signs.
The
myelin
Myelin is a lipid-rich material that surrounds nerve cell axons (the nervous system's "wires") to insulate them and increase the rate at which electrical impulses (called action potentials) are passed along the axon. The myelinated axon can be ...
ation of the pyramidal fibres is incomplete at birth and gradually progresses in cranio-caudal direction and thereby progressively
gaining functionality. Most of the myelination is complete by two years of age and thereafter it progresses very slowly in cranio-caudal direction up to twelve years of age.
Structure
The term ''pyramidal tracts'' refers to
upper motor neuron
Upper motor neurons (UMNs) is a term introduced by William Gowers in 1886. They are found in the cerebral cortex and brainstem and carry information down to activate interneurons and lower motor neurons, which in turn directly signal muscles t ...
s that originate in the
cerebral cortex
The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
and terminate in the
spinal cord
The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spi ...
(''corticospinal'') or
brainstem
The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...
(''corticobulbar''). Nerves emerge in the
cerebral cortex
The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
, pass down and may
cross sides in the
medulla oblongata, and travel as part of the
spinal cord
The spinal cord is a long, thin, tubular structure made up of nervous tissue, which extends from the medulla oblongata in the brainstem to the lumbar region of the vertebral column (backbone). The backbone encloses the central canal of the spi ...
until they
synapse
In the nervous system, a synapse is a structure that permits a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or to the target effector cell.
Synapses are essential to the transmission of nervous impulses from ...
with
interneuron
Interneurons (also called internuncial neurons, relay neurons, association neurons, connector neurons, intermediate neurons or local circuit neurons) are neurons that connect two brain regions, i.e. not direct motor neurons or sensory neurons. I ...
s in the
grey column
The grey column refers to a somewhat ridge-shaped mass of grey matter in the spinal cord. This presents as three columns: the anterior grey column, the posterior grey column, and the lateral grey column, all of which are visible in cross-section ...
of the spinal cord.
There is some variation in terminology. The ''pyramidal tracts'' definitively encompass the
corticospinal tract
The corticospinal tract is a white matter motor pathway starting at the cerebral cortex that terminates on lower motor neurons and interneurons in the spinal cord, controlling movements of the limbs and trunk. There are more than one million neur ...
s, and many authors also include the
corticobulbar tract
In neuroanatomy, the corticobulbar (or corticonuclear) tract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata (also called ...
s.
Corticospinal tract
Nerve fibres in the corticospinal tract originate from
pyramidal cells
Pyramidal cells, or pyramidal neurons, are a type of multipolar neuron found in areas of the brain including the cerebral cortex, the hippocampus, and the amygdala. Pyramidal neurons are the primary excitation units of the mammalian prefrontal cor ...
in layer V of the
cerebral cortex
The cerebral cortex, also known as the cerebral mantle, is the outer layer of neural tissue of the cerebrum of the brain in humans and other mammals. The cerebral cortex mostly consists of the six-layered neocortex, with just 10% consisting of ...
. Fibres arise from the
primary motor cortex
The primary motor cortex (Brodmann area 4) is a brain region that in humans is located in the dorsal portion of the frontal lobe. It is the primary region of the motor system and works in association with other motor areas including premotor co ...
(about 30%),
supplementary motor area
The supplementary motor area (SMA) is a part of the motor cortex of primates that contributes to the control of movement. It is located on the midline surface of the hemisphere just in front of (anterior to) the primary motor cortex leg representa ...
and the
premotor cortex
The premotor cortex is an area of the motor cortex lying within the frontal lobe of the brain just anterior to the primary motor cortex. It occupies part of Brodmann's area 6. It has been studied mainly in primates, including monkeys and humans. ...
(together also about 30%), and the
somatosensory cortex
In physiology, the somatosensory system is the network of neural structures in the brain and body that produce the perception of touch (haptic perception), as well as temperature (thermoception), body position (proprioception), and pain. It is ...
,
parietal lobe
The parietal lobe is one of the four major lobes of the cerebral cortex in the brain of mammals. The parietal lobe is positioned above the temporal lobe and behind the frontal lobe and central sulcus.
The parietal lobe integrates sensory informa ...
, and
cingulate gyrus
The cingulate cortex is a part of the brain situated in the medial aspect of the cerebral cortex. The cingulate cortex includes the entire cingulate gyrus, which lies immediately above the corpus callosum, and the continuation of this in the ci ...
supplies the rest.
The cells have their
bodies
Bodies may refer to:
* The plural of body
* ''Bodies'' (2004 TV series), BBC television programme
* Bodies (upcoming TV series), an upcoming British crime thriller limited series
* "Bodies" (''Law & Order''), 2003 episode of ''Law & Order''
* ...
in the cerebral cortex, and the
axon
An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve fibre: see spelling differences), is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as action po ...
s form the bulk of the pyramidal tracts.
The nerve axons travel from the cortex through the
posterior limb of internal capsule, through the
cerebral peduncle
The cerebral peduncles are the two stalks that attach the cerebrum to the brainstem. They are structures at the front of the midbrain which arise from the ventral pons and contain the large ascending (sensory) and descending (motor) nerve tra ...
and into the
brainstem
The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is cont ...
and anterior
medulla oblongata. Here they form two prominences called the
medulla oblongatary pyramids. Below the prominences, the majority of axons cross over to the opposite side from which they originated, known as
decussation
Decussation is used in biological contexts to describe a crossing (due to the shape of the Roman numeral for ten, an uppercase 'X' (), ). In Latin anatomical terms, the form is used, e.g. .
Similarly, the anatomical term chiasma is named aft ...
. The axons that cross over move to the outer part of the medulla oblongata and form the
lateral corticospinal tract
The lateral corticospinal tract (also called the crossed pyramidal tract or lateral cerebrospinal fasciculus) is the largest part of the corticospinal tract. It extends throughout the entire length of the spinal cord, and on transverse section appe ...
, whereas the fibres that remain form the
anterior corticospinal tract
The anterior corticospinal tract (also called the ventral corticospinal tract, "Bundle of Turck", medial corticospinal tract, direct pyramidal tract, or anterior cerebrospinal fasciculus) is a small bundle of descending fibers that connect the cer ...
.
About 80% of axons cross over and form the lateral corticospinal tract; 10% do not cross over and join the tract, and 10% of fibres travel in the anterior corticospinal tract.
The nerve axons traveling down the tract are the
efferent nerve fiber
Efferent nerve fibers refer to axonal projections that ''exit'' a particular region; as opposed to afferent projections that ''arrive'' at the region. These terms have a slightly different meaning in the context of the peripheral nervous syste ...
s of the
upper motor neuron
Upper motor neurons (UMNs) is a term introduced by William Gowers in 1886. They are found in the cerebral cortex and brainstem and carry information down to activate interneurons and lower motor neurons, which in turn directly signal muscles t ...
s. These axons travel down the tracts in the
white matter
White matter refers to areas of the central nervous system (CNS) that are mainly made up of myelinated axons, also called tracts. Long thought to be passive tissue, white matter affects learning and brain functions, modulating the distribution ...
of the spinal cord until they reach the
vertebra
The spinal column, a defining synapomorphy shared by nearly all vertebrates,Hagfish are believed to have secondarily lost their spinal column is a moderately flexible series of vertebrae (singular vertebra), each constituting a characteristic ...
l level of the muscle that they will innervate.
[ At this point, the axons ]synapse
In the nervous system, a synapse is a structure that permits a neuron (or nerve cell) to pass an electrical or chemical signal to another neuron or to the target effector cell.
Synapses are essential to the transmission of nervous impulses from ...
with lower motor neuron
Lower motor neurons (LMNs) are motor neurons located in either the anterior grey column, anterior nerve roots (spinal lower motor neurons) or the cranial nerve nuclei of the brainstem and cranial nerves with motor function (cranial nerve lower mo ...
s. The majority of axons do not directly synapse with lower motor neurons, but instead synapse with an interneuron
Interneurons (also called internuncial neurons, relay neurons, association neurons, connector neurons, intermediate neurons or local circuit neurons) are neurons that connect two brain regions, i.e. not direct motor neurons or sensory neurons. I ...
that then synapses with a lower motor neuron. This generally occurs in the anterior grey column
The anterior grey column (also called the anterior cornu, anterior horn of spinal cord, motor horn or ventral horn) is the front column of grey matter in the spinal cord. It is one of the three grey columns. The anterior grey column contains motor ...
. Nerve axons of the lateral corticospinal tract that did not cross over in the medulla oblongata do so at the level of the spinal cord they terminate in.
These tracts contain more than 1 million axons and the majority of the axons are myelinated. The corticospinal tracts myelinate largely during the first and second years after birth. The majority of nerve axons are small (<4μm) in diameter. About 3% of nerve axons have a much larger diameter (16μm) and arise from Betz cell
Betz cells (also known as pyramidal cells of Betz) are giant pyramidal cells (neurons) located within the fifth layer of the grey matter in the primary motor cortex. These neurons are the largest in the central nervous system, sometimes reaching ...
s, mostly in the leg area of the primary motor cortex. These cells are notable because of their rapid conduction rate, over 70m/sec, the fastest conduction of any signals from the brain to the spinal cord.
Corticobulbar tract
Fibres from the ventral
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek language, Greek roots, describe something in its standard anatomical position. Th ...
motor cortex
The motor cortex is the region of the cerebral cortex believed to be involved in the planning, control, and execution of voluntary movements.
The motor cortex is an area of the frontal lobe located in the posterior precentral gyrus immediately ...
travel with the corticospinal tract through the internal capsule, but terminate in a number of locations in the midbrain
The midbrain or mesencephalon is the forward-most portion of the brainstem and is associated with vision, hearing, motor control, sleep and wakefulness, arousal (alertness), and temperature regulation. The name comes from the Greek ''mesos'', " ...
(cortico-mesencephalic tract In neuroanatomy, corticomesencephalic tract is a descending nerve tract that originates in the Frontal eye fields, frontal eye field (Brodmann area 8) and terminate in the midbrain. Its fibers mediate conjugate eye movement.
Structure
The cortico ...
), pons
The pons (from Latin , "bridge") is part of the brainstem that in humans and other bipeds lies inferior to the midbrain, superior to the medulla oblongata and anterior to the cerebellum.
The pons is also called the pons Varolii ("bridge of Va ...
(Corticopontine tract
Corticopontine fibers are projections from the cerebral cortex to the pontine nuclei.
Depending upon the lobe of origin, they can be classified as frontopontine fibers, parietopontine fibers, temporopontine fibers
In the human nervous syste ...
), and medulla oblongata (cortico-bulbar tract
In neuroanatomy, the corticobulbar (or corticonuclear) tract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the Medullary pyramids (brainstem), medullary pyramids, which are part of the brainstem' ...
). The upper motor neuron
Upper motor neurons (UMNs) is a term introduced by William Gowers in 1886. They are found in the cerebral cortex and brainstem and carry information down to activate interneurons and lower motor neurons, which in turn directly signal muscles t ...
s of the corticobulbar tract synapse with interneurons or directly with the lower motor neurons located in the motor cranial nerve nuclei
A cranial nerve nucleus is a collection of neurons (gray matter) in the brain stem that is associated with one or more of the cranial nerves. Axons carrying information to and from the cranial nerves form a synapse first at these nuclei. Lesions ...
, namely oculomotor
The oculomotor nerve, also known as the third cranial nerve, cranial nerve III, or simply CN III, is a cranial nerve that enters the orbit (anatomy), orbit through the superior orbital fissure and innervates extraocular muscles that enable mo ...
, trochlear, motor nucleus of the trigeminal nerve
In neuroanatomy, the trigeminal nerve ( lit. ''triplet'' nerve), also known as the fifth cranial nerve, cranial nerve V, or simply CN V, is a cranial nerve responsible for sensation in the face and motor functions such as biting and chewin ...
, abducens
The abducens nerve or abducent nerve, also known as the sixth cranial nerve, cranial nerve VI, or simply CN VI, is a cranial nerve in humans and various other animals that controls the movement of the lateral rectus muscle, one of the extraocula ...
, facial nerve
The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of tas ...
and accessory and in the nucleus ambiguus
The nucleus ambiguus ("ambiguous nucleus" in English) is a group of large motor neurons, situated deep in the medullary reticular formation named by Jacob Clarke. The nucleus ambiguus contains the cell bodies of neurons that innervate the muscle ...
to the hypoglossal
The hypoglossal nerve, also known as the twelfth cranial nerve, cranial nerve XII, or simply CN XII, is a cranial nerve that innervates all the extrinsic and intrinsic muscles of the tongue except for the palatoglossus, which is innervated by ...
, vagus
The vagus nerve, also known as the tenth cranial nerve, cranial nerve X, or simply CN X, is a cranial nerve that interfaces with the parasympathetic control of the heart, lungs, and digestive tract. It comprises two nerves—the left and right v ...
and accessory nerve
The accessory nerve, also known as the eleventh cranial nerve, cranial nerve XI, or simply CN XI, is a cranial nerve that supplies the sternocleidomastoid and trapezius muscles. It is classified as the eleventh of twelve pairs of cranial nerv ...
s. These nuclei are supplied by nerves from both sides of the brain, with the exception of the parts of the facial nerve that control muscles of the lower face. These muscles are only innervated by nerves from the contralateral (opposite) side of the cortex.
Function
The nerves within the corticospinal tract are involved in movement of muscle
Skeletal muscles (commonly referred to as muscles) are organs of the vertebrate muscular system and typically are attached by tendons to bones of a skeleton. The muscle cells of skeletal muscles are much longer than in the other types of muscl ...
s of the body. Because of the crossing-over of fibres, muscles are supplied by the side of the brain opposite to that of the muscle. The nerves within the corticobulbar tract are involved in movement in muscles of the head. They are involved in swallowing, phonation
The term phonation has slightly different meanings depending on the subfield of phonetics. Among some phoneticians, ''phonation'' is the process by which the vocal folds produce certain sounds through quasi-periodic vibration. This is the defini ...
, and movements of the tongue. By virtue of involvement with the facial nerve
The facial nerve, also known as the seventh cranial nerve, cranial nerve VII, or simply CN VII, is a cranial nerve that emerges from the pons of the brainstem, controls the muscles of facial expression, and functions in the conveyance of tas ...
, the corticobulbar tract is also responsible for transmitting facial expression
A facial expression is one or more motions or positions of the muscles beneath the skin of the face. According to one set of controversial theories, these movements convey the emotional state of an individual to observers. Facial expressions are a ...
. With the exception of lower muscles of facial expression, all functions of the corticobulbar tract involve inputs from both sides of the brain.
The extrapyramidal system
In anatomy, the extrapyramidal system is a part of the motor system network causing involuntary actions. The system is called ''extrapyramidal'' to distinguish it from the tracts of the motor cortex that reach their targets by traveling through t ...
refers to tracts within the spinal cord involved in involuntary movement but not part of the pyramidal tracts. Their functions include the control of posture and muscle tone
In physiology, medicine, and anatomy, muscle tone (residual muscle tension or tonus) is the continuous and passive partial muscle contraction, contraction of the muscles, or the muscle's resistance to passive stretch during resting state.O’Sull ...
.
Clinical significance
# Damage to the fibres of the corticospinal tracts, anywhere along their course from the cerebral cortex to the lower end of the spinal cord, can cause an upper motor neuron syndrome Upper motor neuron syndrome (UMNS) is the motor control changes that can occur in skeletal muscle after an upper motor neuron lesion.
Following upper motor neuron lesions, affected muscles potentially have many features of altered performance inclu ...
.
# A few days after the injury to the upper motor neurons, a pattern of motor signs and symptoms appears, including spasticity
Spasticity () is a feature of altered skeletal muscle performance with a combination of paralysis, increased tendon reflex activity, and hypertonia. It is also colloquially referred to as an unusual "tightness", stiffness, or "pull" of muscles ...
, hyperactive reflexes, a loss of the ability to perform fine movements, and an extensor
In anatomy, extension is a movement of a joint that increases the angle between two bones or body surfaces at a joint. Extension usually results in straightening of the bones or body surfaces involved. For example, extension is produced by extendin ...
plantar
Standard anatomical terms of location are used to unambiguously describe the anatomy of animals, including humans. The terms, typically derived from Latin or Greek roots, describe something in its standard anatomical position. This position prov ...
response known as the Babinski sign
The plantar reflex is a reflex elicited when the sole of the foot is stimulated with a blunt instrument. The reflex can take one of two forms. In healthy adults, the plantar reflex causes a downward response of the hallux (flexion). An upward re ...
.
# Symptoms generally occur alongside other sensory problems.
# Causes may include disorders such as stroke
A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
s, cerebral palsy
Cerebral palsy (CP) is a group of movement disorders that appear in early childhood. Signs and symptoms vary among people and over time, but include poor coordination, stiff muscles, weak muscles, and tremors. There may be problems with sensa ...
, subdural hemorrhage
A subdural hematoma (SDH) is a type of bleeding in which a collection of blood—usually but not always associated with a traumatic brain injury—gathers between the inner layer of the dura mater and the arachnoid mater of the meninges surround ...
, abscess
An abscess is a collection of pus that has built up within the tissue of the body. Signs and symptoms of abscesses include redness, pain, warmth, and swelling. The swelling may feel fluid-filled when pressed. The area of redness often extends b ...
es and tumour
A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
s, neurodegenerative diseases such as multiple system atrophy
Multiple system atrophy (MSA) is a rare neurodegenerative disorder characterized by autonomic dysfunction, tremors, slow movement, muscle rigidity, and postural instability (collectively known as parkinsonism) and ataxia. This is caused by progr ...
, inflammation such as meningitis
Meningitis is acute or chronic inflammation of the protective membranes covering the brain and spinal cord, collectively called the meninges. The most common symptoms are fever, headache, and neck stiffness. Other symptoms include confusion or ...
and multiple sclerosis
Multiple (cerebral) sclerosis (MS), also known as encephalomyelitis disseminata or disseminated sclerosis, is the most common demyelinating disease, in which the insulating covers of nerve cells in the brain and spinal cord are damaged. This d ...
, and trauma to the spinal cord, including from slipped discs.
# If the corticobulbar tract
In neuroanatomy, the corticobulbar (or corticonuclear) tract is a two-neuron white matter motor pathway connecting the motor cortex in the cerebral cortex to the medullary pyramids, which are part of the brainstem's medulla oblongata (also called ...
is damaged on only one side, then only the lower face will be affected, however if there is involvement of both the left and right tracts, then the result is pseudobulbar palsy
Pseudobulbar palsy is a medical condition characterized by the inability to control facial movements (such as chewing and speaking) and caused by a variety of neurological disorders. Patients experience difficulty chewing and swallowing, have in ...
. This causes problems with swallowing, speaking, and emotional lability
In medicine and psychology, emotional lability is a sign or symptom typified by exaggerated changes in mood or affect in quick succession. Sometimes the emotions expressed outwardly are very different from how the person feels on the inside. Thes ...
.
# Severe disabling involuntary movements such as hemiballismus
Hemiballismus or hemiballism is a basal ganglia syndrome resulting from damage to the subthalamic nucleus in the basal ganglia. Hemiballismus is a rare hyperkinetic movement disorder, that is characterized by violent involuntary limb movements, ...
or severe chorea
Chorea (or choreia, occasionally) is an abnormal involuntary movement disorder, one of a group of neurological disorders called dyskinesias. The term ''chorea'' is derived from the grc, χορεία ("dance"; see choreia), as the quick movement ...
might exhaust the patient and become a life-threatening situation.
# In the past, this condition was treated by partial section of the pyramidal tract either at the primary motor cortex
The primary motor cortex (Brodmann area 4) is a brain region that in humans is located in the dorsal portion of the frontal lobe. It is the primary region of the motor system and works in association with other motor areas including premotor co ...
or at the cerebral crus
The cerebral crus (crus cerebri) is the Anatomical terms of location, anterior portion of the cerebral peduncle which contains the motor tracts, travelling from the cerebral cortex to the pons and spine. The plural of which is cerebral crura.
In ...
(pedunculotomy).
Additional images
File:Gray683.png, Dissection of brain-stem. Lateral view.
File:Gray689.png, Superficial dissection of brain-stem. Ventral view.
File:Gray764.png, The motor tract.
File:Medulla spinalis - tracts - English.svg
File:Gray672.png, Diagram of the principal fasciculi of the spinal cord, from Gray's anatomy
''Gray's Anatomy'' is a reference book of human anatomy written by Henry Gray, illustrated by Henry Vandyke Carter, and first published in London in 1858. It has gone through multiple revised editions and the current edition, the 42nd (Octob ...
In popular culture
In ''National Lampoon's European Vacation
''National Lampoon's European Vacation'' is a 1985 American comedy film directed by Amy Heckerling and written by Robert Klane. The second film in National Lampoon's ''Vacation'' film series, it stars Chevy Chase, Beverly D'Angelo, Dana Hill, ...
'', the Griswold family wins a vacation on a game show called ''Pig in a Poke'' when their opponents fail to correctly answer a question about the pyramidal tracts, despite Clark Griswold (played by Chevy Chase) mistakenly answering that they are a housing development outside Cairo.
References
External links
*
McGill
*
{{Authority control
Central nervous system pathways
Motor system