Spasticity

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Spasticity Classification and external resources
DiseasesDB	20872
eMedicine	neuro/706 pmr/177
MeSH	D009128

Spasticity or muscular hypertonicity is a disorder of the body motor system, and especially the central nervous system (CNS), in which certain muscles are continuously contracted. This contraction causes stiffness or tightness of the muscles and may interfere with gait, movement, and speech. Depending on severity, the person with the spastic muscles may or may not feel it. However, it can often be severely disabling . The human motor system is not always linked with the sensory systems, nor the voluntary-muscle systems.

1 Presentation
2 Possible benefits
3 Treatment
4 Prognosis
5 See also
6 References
7 External links

[edit] Presentation

Symptoms may include hypertonia (increased muscle tone), clonus (a series of rapid muscle contractions), exaggerated deep tendon reflexes, muscle spasms, scissoring (involuntary crossing of the legs), and fixed joints (contractures). The degree of spasticity varies from mild muscle stiffness to severe, painful, and uncontrollable muscle spasms.

The condition can interfere with rehabilitation in patients with certain disorders, and often interferes with daily activities. Over the years, it may increase in its effect, so more severe treatments may be needed later. Cold weather and fatigue can trigger spasms more severely than other times. The constant spasms can lead to muscle fatigue so periodic rest is required but often difficult to achieve. Multi-tasking (such as walking, talking, eating and other activities) can also trigger more severe spasticity.

[edit] Possible benefits

May help some patients to ambulate, stand or transfer (e.g., stand pivot transfers)
May assist in maintaining muscle bulk
May assist in preventing DVTs
May assist in preventing osteoporosis pressure ulcer formation over bony prominences
Can be used as “diagnostic tool” (with increased spasticity being a sign of exposure to a noxious stimuli—infection, bowel impaction, urinary retention, etc) [1]

[edit] Treatment

If the cause is fatigue, the first remedy is rest or relaxation. Massage feels incredibly good but only provides temporary relief. Stretching the muscles involved also feels good but only provides temporary relief. Chronic spasms can lead to shortening of the muscles and ligaments. Regular (daily) exercises over the years ahead of these ligaments and muscles are needed to prevent the pain and the crippling of movement.

Treatment may include such medications as baclofen, diazepam, dantrolene, or clonazepam; muscle stretching, range of motion exercises, and other occupational therapy or physical therapy regimens to help prevent joint contractures (shrinkage or shortening of a muscle) and reduce the severity of symptoms; or surgery for tendon release or to block the connection between nerve and muscle, so that the muscle does not contract. The connection between nerve and muscle may also be blocked temporarily, without surgery, by injecting botulinum toxin into the muscle.

Some USA states have also issued medical marijuana to help treat spasticity.

[edit] Prognosis

The prognosis for those with spasticity depends on the severity of the spasticity and the associated disorder(s). To a small degree spasticity performs the helpful role of exercise, but it is usually bothersome to normal activities in life.

[edit] See also

[edit] References

"Other Complications of Spinal Cord Injury: Spasticity." (Louis Calder Memorial Library of the University of Miami/Jackson Memorial Medical Center, October 3, 2002), http://calder.med.miami.edu/pointis/spasticity.html

Maureen E. Neistadt and Elizabeth Blesedell Crepeau, ed. (1998). Willard and Spackman's occupational therapy. Philadelphia: Lippincott-Raven Publishers, 233. ISBN 0-397-55192-4.