The pyramidal and extrapyramidal tracts are descending (efferent) tracts that execute voluntary (pyramidal) and involuntary (extrapyramidal) movements.

PyramidalExtrapyramidal
OriginCerebral cortexBrainstem
LocalizationPass through the medullary pyramidsDo not pass through the pyramids
FunctionVoluntary muscle controlInvoluntary muscle control (balance) and modulation
TractsRubrospinal
Reticulospinal
Vestibulospinal
Tectospinal		Corticospinal
Corticobulbar
Table 1. Comparison of pyramidal and extrapyramidal tracts

Pyramidal tracts

  • Corticobulbar tract. Voluntary control of the muscles of facial expression, head, and neck; mostly bilateral innervation.
    • Originates in the cerebral cortex (PMC; Brodmann 4) → Genu of the internal capsule → Descends down to the medulla and medullary pyramids, and synapses with the nuclei of CN III, IV, V,




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