Spasticity

What is Spasticity?

Spasticity is a condition of increased muscle tone and a loss of functional mobility. While more common in adults, it can occur in individuals of all ages. Spasticity is different from spasms which are sudden sharp forceful movements. The condition is better described as sustained and involuntary contractions or tightness that leads to stiffness in the limbs, trunk or throughout the entire body.

Spasticity is caused by damage to the brain or spinal cord and can affect any part of the body, but it usually affects the legs, arms and face. It occurs when the damaged neurons send faulty signals from the basal ganglia to the muscles. 

Spasticity is categorized as focal or general spasticity, and is a common complication of central nervous system disorders, such as traumatic brain injury and cerebral palsy.

Most commonly caused by brain or spinal cord injury but may be a result of other factors like:

Symptoms

Spasticity affects people differently, some may have visible spasms and uncontrollable limb movements while others describe stiff limbs and difficulty moving.

Symptoms may include:

  • Muscle stiffness
  • Muscle spasms
  • Involuntary crossing of the legs
  • Muscle and joint deformities
  • Muscle fatigue
  • Inhibition of longitudinal muscle growth
  • Inhibition of protein synthesis in muscle cells
  • Urinary tract infections (UTI)
  • Chronic constipation
  • Frozen joints
  • Fever or systemic illnesses
  • Pressure sores.

Diagnosis

This condition is diagnosed by a neurologist who will work with the patient to identify their symptoms. Spasticity spasms are measured using the Spasm Severity Scale and diagnosis requires an individual to have muscle stiffness for at least three months.

An MRI might be required to provide more information on the source of spasticity and the extent of the damage that has caused it.

Treatment

Spasticity is unique to each individual and treatments should be unique as well. There are a variety of treatment options available. 

Treatment options include:

  • Non Surgical – These treatment options may include physical therapy, occupational therapy, casting or bracing, oral medications or injections.
  • Neurosurgery – Your neurologist may recommend a neurosurgery to alleviate pain caused by spasticity.

    Procedures may include: 

  • Intrathecal Baclofen (ITB) Pump: The neurosurgeon will place a pump in the  patient’s abdomen and release a steady dose of baclofen into the spinal fluid. This procedure significantly reduces pain caused by spasticity and has fewer side effects than long term medications.  ITB pump therapy should only be considered in extreme cases and is most effective in treating the lower and upper extremities.
  • Selective Dorsal Rhizotomy (SDR): SDR balances the electrical signals sent to the spinal cord by cutting selective nerve roots. This surgery is used severe cases affecting the legs. The surgery may decrease muscle stiffness, while allowing the patient to maintain other functions. SDR is most commonly used in patients with cerebral palsy

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