Spasticity

Definition

Spasticity is stiff or rigid muscles with exaggerated, deep tendon reflexes (for example, a knee-jerk reflex). The condition can interfere with walking, movement, or speech.

See also: Muscle cramps

Alternative Names

Muscle stiffness

Considerations

Spasticity generally results from damage to the part of the brain that controls voluntary movement. It may also occur when you have damage to the nerves traveling from brain down to spinal cord.

Symptoms of spasticity include:

• Exaggerated deep tendon reflexes (the knee-jerk reflex)
• Scissoring (crossing of the legs as the tips of scissors would close)
• Repetitive jerky motions (clonus)
• Unusual posturing
• Carrying the shoulder, arm, wrist, and finger at an abnormal angle

Spasticity may also interfere with speech. Severe, long-term spasticity may lead to contracture of muscles, causing joints to be bent at a fixed position.

Causes

• Cerebral palsy
• Brain damage caused by lack of oxygen, as can occur in near drowning or near suffocation
• Brain trauma
• Severe head injury
• Spinal cord injury
• Stroke
• Adrenoleukodystrophy
• Phenylketonuria
• Neurodegenerative illness
• Multiple sclerosis

This list is not all inclusive.

Home Care

Exercise, including muscle stretching, can help make your symptoms less severe.

When to Contact a Medical Professional

Contact your health care provider if:

• The spasticity worsens
• Contracture deformities appear to be developing
• Your condition gets worse

What to Expect at Your Office Visit

Your doctor will perform a physical exam and ask questions about your symptoms, including:

• When was it first noticed?
• How long has it lasted?
• Is it always present?
• How severe is it?
• What muscles are affected?
• What makes it better?
• What makes it worse?
• What other symptoms are also present?

Your doctor may refer you to a physical therapist. Physical therapy consists of variety of exercises, including muscle stretching and strengthening exercises. Physical therapy exercises can be taught to parents who may then help their child perform them at home.

Medicines for spasticity include baclofen, tizanidine, cyclobenzaprine, and benzodiazepines. In rare cases, a pump may be inserted into the spinal fluid to directly deliver medicine to the nervous system.

Botox injections may help relieve spasticity symptoms in some patients.

Sometimes, a person may need surgery to release the tendon or to cut the the nerve-muscle pathway.

References

Goetz, CG. Textbook of Clinical Neurology. 2nd ed. St. Louis, Mo: WB Saunders; 2003: 236, 247, 254.

Goldman L, Ausiello D. Cecil Textbook of Medicine. 22nd ed. Philadelphia, Pa: WB Saunders; 2004:2324.