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Spasticity is a problem with muscles, mainly due to excessive tension and restriction of their mobility. The causes of spasticity can be both nerve tissue injuries and multiple sclerosis or a brain tumor. Spasticity is often a serious problem because it can lead to severe pain or difficulty moving.
Spasticityis a term derived from the Greek wordspasticos , which literally translates to "pulling" or "pulling". This disorder affects the muscles and consists in excessive muscle tension, accompanied by the appearance of resistance when trying to perform passive movements with the muscles involved in the pathology.
Muscle dysfunction in the form of spasticity may occur in patients of various age groups - the problem may be observed in children basically from the moment they are born, but it can also be a pathology acquired later in life. This possibility is because there are many different potential causes of spasticity.
Spasticity: causes
Spasticity does manifest itself as dysfunction of the muscle tissue, but is caused by disturbances in the nervous tissue. The causes of spasticity are various conditions in which there is damage to the elements of the nervous system involved in the control of motor activities, such as: motor centers within the cerebral cortex itself, cortico-spinal tract (i.e. the nerve connections between the cerebral cortex and the spinal cord) or the spinal cord itself. cord. Generally speaking, it is possible to say that spasticity is caused by damage to the so-called upper motor neuron.
Under physiological conditions, muscles receive two types of signals: some of them stimulate them to function, others are designed to inhibit muscle activity. In a situation when any of the above-mentioned parts of the nervous system is damaged, the balance between the two types of stimuli is disturbed - stimuli stimulating the muscles to work begin to dominate, which ultimately results in the fact that sensory stimuli, even of minimal intensity, can lead to muscle contraction and the onset of spasticity.
ImportantThere are many different states that this can occur indamage to the motor cortex of the brain, cortical-spinal tract or spinal cord. The most common causes of spasticity are:
- injuries (spine or head),
- bleeding into the structures of the nervous system,
- multiple sclerosis,
- cerebral palsy,
- tumors of the central nervous system,
- strokes.
Spasticity: diagnostics
The first test performed in patients with spasticity is usually a neurological test. In addition to the aforementioned deviations, neurologists can also find other pathologies in patients, such as an increase in tendon reflexes or the presence of polyclonic reflexes (e.g. in the form of foot tremors).
Other tests that are performed on patients experiencing spasticity depend on the suspected cause of the problem. For example, if a patient has had a head injury or there is a possibility that a CNS tumor may have developed, they will undergo imaging tests, such as computed tomography or magnetic resonance imaging of the head. On the other hand, if it is suspected that the cause of spasticity may be multiple sclerosis, in addition to imaging diagnostics, the patient may undergo a lumbar puncture, the purpose of which will be to collect and then analyze the composition of his cerebrospinal fluid.
Spasticity: treatment
The problem with these muscle dysfunctions is that most often the damage to the nervous system that causes spasticity is irreversible. However, implementation of therapeutic interactions in patients with spasticity is necessary due to the fact that in the absence of treatment there is a risk, e.g. the appearance of permanent muscle contractures and related deformations of joint and bone structures in patients. In addition, spasticity can lead to a significant intensity of pain, and also make it difficult for patients to perform basic activities, such as personal hygiene or simply moving around.
Treatment of spasticity is often associated with various difficulties, however, patients with this disorder should never stop treatment.
In the treatment of spasticity, mainly rehabilitation and pharmacotherapy are used. Working with a physiotherapist is aimed at preventing the aforementioned contractures and their consequences, but also allowing patients to maintain the greatest possible mobility. Pharmacological treatment of spasticity usually consists in taking orally by patients various medications, such as e.g.baclofen, benzodiazepines (e.g. diazepam or clonazepam) or dantrolene. In patients with an extremely severe course of spasticity, it is possible to implant them special pumps that will continuously deliver baclofen to the inside of the spinal canal.
In addition to those already described, sometimes surgical techniques are also used to treat spasticity. Patients can be given injections of botulinum toxin - this substance paralyzes muscle activity and reduces spasticity. The limitation of such therapy is that the effects of the injection last only for a few months - after this time, in order to still be able to observe the effects of the treatment, it is necessary to re-administer the botulinum toxin to the patient. It is also possible to use other procedures, such as, for example, rhizotomy (i.e. cutting the nerve roots supplying the muscles affected by spasticity). Currently, more and more attempts are made to use the technique of deep brain stimulation (DBS) in the treatment of spasticity.
About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.