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The word extrapyramidal is used in various ways. In neurology, extrapyramidal describes disorders such as Parkinson’s disease – the slowing, stiffness and/or tremor. Extrapyramidal is also sometimes used to include dyskinesias, such as chorea, hemiballismus or dystonia. In neuroanatomy, as a more general term, extrapyramidal relates to the basal ganglia region (Figure 2.3), that is:

Figure 2.2 Descending corticospinal pathways.

Source: Champney (2016).

Figure 2.3 Oblique coronal section: putamen, caudate, globus pallidus, subthalamic nucleus, substantia nigra.

Source: Champney (2016).

 The striatum (caudate nucleus, putamen of lentiform nucleus, nucleus accumbens);

 Globus pallidus (GP) – lateral and medial parts. The GP extends into the pars reticularis of the substantia nigra;

 Subthalamic nucleus

 Pars compacta of the substantia nigra.

Figure 2.4 A striatal motor loop. SMA ‐ supplementary motor area, VLN ‐ ventral lateral nucleus of thalamus, STN ‐ subthalamic nucleus, GPL ‐ globus pallidus (lateral), GPM ‐ globus pallidus (medial), SNpc ‐ substantia nigra pars compacta, CST‐ corticospinal tract.

Source: Fitzgerald (2010).