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spasticity

Abnormally increased tone in a muscle. Etiology: - upper motor neuron disease - stroke - multiple sclerosis Clinical manifestations: 1) increased tone, clonus, spasms, spastic dystonia & co-contractions [3] 2) velocity-dependent 3) sudden release after reaching maximum velocity (clasp-knife phenomenon) 4) predominantly affects anti-gravity muscles a) upper limb flexors more than extensors b) lower limb extensors more than flexors 5) distinct from rigidity & paratonia (2 other types of increased muscle tone) 6) may be painful [3] 7) may be exacerbated by comormid factors - constipation, urinary tract infections, pressure ulcers Management: - antispasmodic - baclofen, tizanidine, dantrolene [3] - botulinum toxin (Botox) injections [3]

Related

muscle tone spastic paraplegia

Specific

upper limb spasticity

General

sign/symptom

References

  1. nlmpubs.nlm.nih.gov/hstat/ahcpr/
  2. Harrison's Principles of Internal Medicine, 14th ed. Fauci et al (eds), McGraw-Hill Inc. NY, 1998, pg 107
  3. Kheder A, Nair KP. Spasticity: pathophysiology, evaluation and management. Pract Neurol. 2012 Oct;12(5):289-98. PMID: 22976059
  4. NINDS Spasticity Information Page https://www.ninds.nih.gov/Disorders/All-Disorders/Spasticity-Information-page