Spasticity

Spasticity

The term spasm or spasticity comes from the Greek and means something like “spasm”. Spasticity is a hardening and stiffening of muscles, which means that movements become uncontrollable.

What is spasticity?

Spasticity is not a disease in its own right, but a symptom of a disease or injury to the central nervous system. Damage to the brain or spinal cord always plays a role. For nbia explanations, please visit aviationopedia.com.

The voluntary movements of the body are coordinated by the central nervous system; if there is an injury here, the transmission of signals from the nerves to the muscles is impaired. The consequence of this is an uncoordinated muscle contraction, which leads to hardening and stiffening.

This muscle tension naturally results in unpleasant pain. However, not every spasticity is equally pronounced in those affected. Some people only have limited freedom of movement, while others are completely physically handicapped by the spasticity. So the pattern of spasticity is different for each patient.

Causes

Many different diseases or injuries can be responsible for spasticity. The cause of this symptom is damage to the descending nerve connections from the brain to the spinal cord (pyramidal tract).

However, there is always damage to the unconscious part of the nervous system, the so-called extrapyramidal motor system. This suppresses calming signals to the muscle, which disrupts the regulation of the body’s own reflexes.

The result is painful muscle cramps. One of the most common causes of spasticity is stroke, which destroys motor regions of the brain. In addition, cerebral hemorrhage, tumors in the spinal cord or in the brain, injuries or inflammation of the central nervous system, multiple sclerosis, brain damage in children (usually due to lack of oxygen at birth) and neurodegenerative diseases can trigger spasticity.

Symptoms, Ailments & Signs

Spasticity is very individual. At best, it can only exist in a very light form and cause no significant restrictions. At the other end are severe symptoms that result in serious physical disability.

In principle, spasticity can affect any muscle. Flaccid paralysis often precedes spastic paralysis. Furthermore, four forms of spasticity are distinguished, each showing different symptoms. Paralysis of a limb represents monospasticity; the paralysis of both legs represents paraspasticity; paralysis of one side of the body represents hemispasm; the paralysis of all extremities represents tetraspasticity. The latter can also be accompanied by paralysis of the trunk or neck.

Other symptoms associated with spasticity include paralysis of the eyes or larynx. It can then lead to squinting, speech and swallowing problems and slowed look and speech reflexes. The reflexes in spastic people are often expansive, follow incorrect movement patterns, or are delayed.

Sometimes there are involuntary movements. Eye-hand coordination can be severely impaired. Movements are sometimes very difficult to carry out for those affected. Spasticity can be associated with pain. In the case of congenital spasticity, the early childhood reflexes are also retained. Those affected keep the palmar reflex, for example.

Diagnosis & History

A detailed clinical-neurological examination is necessary for the diagnosis of spasticity. This initially focuses on the precise analysis of the causal neurological disease. Since spasticity often does not crystallize until a few weeks or months after nerve damage, incidents from the more distant past must also be included in the diagnosis.

This can be spinal surgery, infections, strokes or nerve-damaging accidents. Spasticity can affect a wide variety of body regions. In general, a distinction is made between monospasticity (spasticity of a single limb), tetraspasticity (spastic paralysis of all extremities), hemispasticity (spasticity of one half of the body) and paraspasticity (spastic paralysis of the legs).

The eye, swallowing and speech muscles can also be affected by spasticity, which leads to further limitations in the patient.

Complications

Spasticity has a very negative effect on the life and everyday life of the person affected. However, the further course depends very much on the exact severity of the spasticity, so that a universal prognosis cannot usually be given. However, the patients suffer from various types of paralysis or sensory disturbances.

This can also lead to swallowing difficulties, so that the usual intake of food and liquids is not easily possible for the patient. The reflexes and movements of the muscles are also significantly slowed down and muscle atrophy occurs. Especially in children, spasticity can also lead to teasing or bullying and thus also cause psychological problems or depression. Those affected often suffer from involuntary movements and convulsions.

Disorders of coordination and cramps in the muscles can also occur and make everyday life of those affected significantly more difficult. A causal treatment of spasticity is unfortunately not possible. Those affected are dependent on various therapies that are intended to make everyday life easier. Life expectancy is usually not reduced by spasticity. Unfortunately, a completely positive course of the disease cannot be achieved.

When should you go to the doctor?

In the case of spasticity, a doctor must be consulted. Self-healing is not possible with this disease, so that the affected person is always dependent on medical treatment. In most cases, spasticity cannot be completely cured, but the symptoms can be alleviated, making everyday life easier for the patient. A doctor should be consulted if the person concerned suffers from involuntary twitching in the muscles. Paralysis of muscles can also indicate spasticity and should be examined by a doctor.

Many of those affected are also unable to speak or swallow properly, so that the intake of food and liquids is also made significantly more difficult due to the spasticity. If these symptoms occur, a doctor must be consulted immediately. The sooner the doctor is consulted, the better the further course of the disease. Spasticity can be diagnosed by a pediatrician or a general practitioner. However, further treatment depends very much on the severity and type of spasticity and is then carried out by a specialist.

Treatment & Therapy

It is not possible to heal spasticity completely, but the individual signs of the disease can be treated symptomatically. Since this is a complex clinical picture, it is advantageous to treat spasticity with the involvement of doctors from different disciplines.

Each patient receives a treatment plan individually tailored to their symptoms. The most important thing here is to achieve an approximate restoration of the motor skills lost through the spasticity. Since our brain is able to retrain such things, a functional restoration can be achieved, for example, through occupational therapy, physiotherapy or similar measures.

The movement therapy aims to train the affected muscle groups in a targeted manner, which can be achieved, for example, by training on certain therapy devices. In some cases, certain movement exercises are also supported by the use of splints or plaster casts. Therapeutic riding is also a suitable means of counteracting spasticity.

Of course, there are also various drug treatments that are used for spastic paralysis. A proven remedy here is botulinum toxin, which is administered by injection into the affected muscle. In the case of spasticity, oral medications are also used to relax muscles and to inhibit neuromuscular transmission of stimuli. However, the undesirable side effects are often greater than the hoped-for effect of combating spasticity.

Prevention

Preventative measures to prevent the spasticity from expanding are, for example, surgical interventions to prevent a deformation or to counteract an aggravation of the spastic movement pattern. These include, for example, the lengthening of tendons, bone changes or muscle transfers.

Aftercare

The extent to which follow-up care is necessary depends on the symptoms of spasticity. In principle, two extremes can be distinguished: Some of those affected remain in a spastic state for the rest of their lives, while others can take part in their usual everyday life if the symptoms persist. This means that aftercare has the functions of everyday support and long-term treatment.

Exercise therapy in particular has proven effective in alleviating the symptoms. Patients have sessions with a therapist prescribed by their treating physician. The intensity of the exercises depends on the individual level of symptoms. In addition to this, they use suitable aids in their everyday life that enable them to be as independent as possible.

Wheelchairs, aids and corsets are often used. There is also a range of anti-spastic drugs. A doctor prescribes suitable means and regularly adjusts them to the clinical picture. Sometimes the question of how an operation can contribute to an improvement in the symptoms also plays a role in the follow-up care.

This prevents deformation, for example. Spasticity can affect every area of ​​life. From the living situation to the practice of work, there are restrictions and effects. This puts a strain on the psyche, especially in adults. Therapy leads to stabilization.

You can do that yourself

If convulsions occur, the person concerned and those present should, if possible, remain calm. Additional stressors or hectic movements should be avoided. They further worsen the general state of health and in no way contribute to improving the situation. Knowing and dealing with first aid measures is important so that life-saving actions can be taken in emergency situations.

Spasticity indicates an underlying disease. This is a symptom and not a disease in its own right. Therefore, the cause of the symptoms must be determined in cooperation with a doctor. Depending on the underlying disease, the further options for self-help are designed. They are therefore individual and must be checked on a case-by-case basis.

What they all have in common is the use of movement therapy. This can also be used independently by the affected person outside of the therapy if possible. Targeted training and exercise units to improve mobility help to cope with the underlying disease and can reduce the occurrence of spasticity. The movement exercises should be carried out daily so that the symptoms are alleviated and the well-being is improved. In addition, a stable social environment is helpful in overcoming the underlying disease.

Spasticity