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muscle spasm
Distinct from muscle rigidity & paratonia.
Etiology:
1) increase in muscle tone due to motor neuron disease
2) hemifacial spasm result from paroxysmal facial nerve activity - tortuous blood vessel adjacent to the facial nerve as it exits the brainstem
a) painless
b) symptoms intermittent & intensified when using facial muscles as in speaking
c) commonly occurs in muscles about the eye
d) may involve entire side of face
Pathology:
1) velocity-dependent
2) sudden release after reaching a maximum (clasp-knife)
3) predominantly effects anti-gravity muscles
a) upper limb flexors more than extensors
b) lower limb extensors more than flexors
Laboratory:
1) serum electrolytes
2) serum Mg+2, serum Ca+2, serum albumin
3) serum creatine kinase
Special laboratory:
1) electromyogram
2) electroencephalogram
Management:
- skeletal muscle relaxant
a) benzodiazepines
b) baclofen
c) cyclobenzaprine
d) tizanidine
- quinine
Related
muscle rigidity
muscle tone
paratonia (gegenhalten)
spasticity
Specific
anal spasm; proctodynia; proctalgia fugax; levator ani syndrome; anal cold
blepharospasm
carpopedal spasm
hemifacial spasm
laryngospasm
General
sign/symptom
References
Harrison's Principles of Internal Medicine, 14th ed.
Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 107, 119