Spasticity: Difference between revisions

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(Created page with "=== Clinic === *Spasticity is a condition in which there is Muscular Hypertonia / Muscle-stiffness. *It might interfere with movement, speech, or Discomfort / Pain. *It is usually caused by damage to UMN and is one of the components of UMN syndrome. *It is often used interchangeably with hypertonia. *It is dependent on the Muscle speed and range of motion and manifests itself when the muscle contracts at high speed. This mea...")
 
 
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=== Clinic ===
=== Clinic ===
*Spasticity is a condition in which there is Muscular Hypertonia / Muscle-stiffness.
*Spasticity is an [[Upper motor neuron, UMN|Upper motor Neuron]] / [[Pyramidal system|Pyramidal]] [[entity]]
*It might interfere with movement, speech, or Discomfort / Pain.
*It is characterized with excessive velocity-dependent muscle contraction
*It is usually caused by damage to [[UMNS, Upper Motor Neuron Syndrome entities|UMN]] and is one of the components of UMN syndrome.
*Spasticity is an exaggerated stretch reflex
*It is often used interchangeably with hypertonia.
*It is characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex
*It is dependent on the Muscle speed and range of motion and manifests itself when the muscle contracts at high speed. This means that when the speed and amplitude of contraction exceeds the threshold, Spasticity occurs
* It results from the loss of inhibition of [[Upper motor neuron, UMN|UMN]], and ends in tightness, stiffness or pull of muscles
* Spasticity naturally depends on Muscle speed and range of motion.
* It manifests itself when the muscle contracts at high speed. This means that when the speed and amplitude of contraction exceeds the threshold, Spasticity occurs
* Depends on the location, Spasticity might cause problem in Movement / Speech or Pain




==== Diagnostic Characters ====
=== Diagnostic Characters ===
*It is asymmetrical because it involves the antagonist muscles
*Asymmetric: Because it involves the antagonist muscles
*it is velocity-dependent and increases in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyper-excitability of the [[Stretch reflex miasms|stretch reflex]] as one component of UMN syndrome
*Velocity-dependent: It increases tonic stretch reflexes and tendon jerks, resulting from hyper-excitability of the [[Stretch reflex miasms|stretch reflex]]  


*It is Strength dependent: Increasing the strength of muscle stretch reflex causes the muscle to contract with greater intensity and power in response to stretching, and this contraction has a direct relationship with the strength of stretching. In this condition, spasticity is occurred.
*Strength dependent: Increasing the strength of muscle stretch reflex causes the muscle to contract with greater intensity and power in response to stretching, and this contraction has a direct relationship with the strength of stretching. In this condition, spasticity is occurred.




=== Analogues ===
=== Entity / Miasm ===
Spasticity  has two analogues
{| class="wikitable"
!
!GSS
!CJD
!NVCJD
!FFI
|-
|[[Hyper reflexia]]
| +++
| +++
| +++
| +++
|-
|[[Spasm]]
| +++
| +++
|
| +++
|-
|[[Hypertonia]]
|
|
| +++
|
|}


# [[Rigidity miasms|Rigidity]]:  Spasticity is distinguished from rigidity by its dependence upon the speed of the muscle stretch and by the presence of other positive UMN signs.
Note that here hypertonia is used in its general meaning. Its rubric is [[spasm]].
# [[Spasm miasms|Spasm]]
=== Causes ===
* It mostly occurs in CNS disorders affecting UMN in the form of a lesion or syndrome
* It can also be present in various types of multiple sclerosis or neuromuscular cerebral palsy
* Spastic [[cerebral palsy]] is the most common form of CP
 
 
=== Mechanism ===
 
* One factor that is thought to be related to spasticity is the stretch reflex
* Combination of decreased inhibition and an increased depolarized state of cell membranes, decreases action potential threshold for nerve signal conduction, and thus increases activity of structures innervated by the affected nerves (spasticity).
* Muscles affected in this way have many other potential features of altered performance in addition to spasticity, including
** Muscle weakness
** Decreased movement control
** [[Clonus]]
** Exaggerated deep tendon reflexes
** Decreased endurance




=== Related entities ===
=== Related entities ===


* [[Clonous miasms|Clonous]]
* [[Clonous|Clonus]]
* [[Fasciculation]]
* [[Myoclonus]]
* Twitching
* [[Rigidity]]
 


=== [[Miasm list|Miasms]] ===
=== Related disease ===


* [[WEE, Eastern & Western Equine Encephalitis|EEE/ WEE]]
* [[Parkinson disease]]
* [[HTLV-1, Human T lymphotropic virus type 1|HTLV-1]]: Esp lower limb spasticity (TSP/HAM)
* [[MS, Multiple Sclerosis|MS]]
*NVCJD
* [[Cerebral palsy|CP]]
*[[WNE, West Nile Encephalitis|WNE]]

Latest revision as of 08:24, 28 September 2023

Clinic

  • Spasticity is an Upper motor Neuron / Pyramidal entity
  • It is characterized with excessive velocity-dependent muscle contraction
  • Spasticity is an exaggerated stretch reflex
  • It is characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex
  • It results from the loss of inhibition of UMN, and ends in tightness, stiffness or pull of muscles
  • Spasticity naturally depends on Muscle speed and range of motion.
  • It manifests itself when the muscle contracts at high speed. This means that when the speed and amplitude of contraction exceeds the threshold, Spasticity occurs
  • Depends on the location, Spasticity might cause problem in Movement / Speech or Pain


Diagnostic Characters

  • Asymmetric: Because it involves the antagonist muscles
  • Velocity-dependent: It increases tonic stretch reflexes and tendon jerks, resulting from hyper-excitability of the stretch reflex
  • Strength dependent: Increasing the strength of muscle stretch reflex causes the muscle to contract with greater intensity and power in response to stretching, and this contraction has a direct relationship with the strength of stretching. In this condition, spasticity is occurred.


Entity / Miasm

GSS CJD NVCJD FFI
Hyper reflexia +++ +++ +++ +++
Spasm +++ +++ +++
Hypertonia +++

Note that here hypertonia is used in its general meaning. Its rubric is spasm.

Causes

  • It mostly occurs in CNS disorders affecting UMN in the form of a lesion or syndrome
  • It can also be present in various types of multiple sclerosis or neuromuscular cerebral palsy
  • Spastic cerebral palsy is the most common form of CP


Mechanism

  • One factor that is thought to be related to spasticity is the stretch reflex
  • Combination of decreased inhibition and an increased depolarized state of cell membranes, decreases action potential threshold for nerve signal conduction, and thus increases activity of structures innervated by the affected nerves (spasticity).
  • Muscles affected in this way have many other potential features of altered performance in addition to spasticity, including
    • Muscle weakness
    • Decreased movement control
    • Clonus
    • Exaggerated deep tendon reflexes
    • Decreased endurance


Related entities


Related disease

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