Overview of movement and cerebellar disorders


  • Voluntary movement requires complex interaction of the corticospinal (pyramidal) tracts, basal ganglia, and cerebellum (the center for motor coordination) to ensure smooth, purposeful movement without extraneous muscular contractions.
    The pyramidal tracts pass through the medullary pyramids to connect the cerebral cortex to lower motor centers of the brain stem and spinal cord.
    The basal ganglia (caudate nucleus, putamen, globus pallidus, subthalamic nucleus, and substantia nigra) form the extrapyramidal system. They are located deep in the forebrain and rostral midbrain. The basal ganglia direct their output mainly through the thalamus to the cerebral cortex (see figure Basal ganglia).
    Most neural lesions that cause movement disorders occur in the extrapyramidal system; thus, movement disorders are sometimes called extrapyramidal disorders.


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