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Central nervous system
Central nervous system


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 or other reflexes)
  • Scissoring (crossing of the legs as the tips of scissors would close)
  • Repetitive jerky motions (clonus), especially when touched or moved
  • Unusual posturing
  • Carrying the shoulder, arm, wrist, and finger at an abnormal angle due to tightness of the muscle

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.



Common Causes:

This list is not all-inclusive.



Home Care:

Exercise, including muscle stretching, can help make your symptoms less severe. Home-based physical therapy is also helpful



Call your health care provider if: Contact your health care provider if:
  • The spasticity worsens
  • Contracture deformities appear to be developing


What to expect at your health care provider's office:

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:

Griggs R, Jozefowicz R, Aminoff M. Approach to the patient with neurologic disease. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 418.

Hammerstad J. Strength and reflexes. In: Goetz, CG, ed. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 15.




Review Date: 3/26/2009
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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Wentworth-Douglass Hospital
789 Central Avenue, Dover, NH 03820
Phone: (603) 742-5252
Toll free: 1 (877) 201-7100