Spasticity, increased muscle tension

Spasticity, spasm or spasm. These terms describe increased muscle tension and muscle cramps. Paralysis may occur later: spastic paralysis. The cause of spasticity can often be found in, among other things, an accident resulting in a spinal cord injury, a congenital abnormality of the brain or spinal cord or a stroke. Things can also go wrong during delivery, causing a shortage of oxygen for the baby.

Spasticity or spasm

Spasticity is a condition in which there is increased muscle tension. A spasm is an involuntary contraction of muscles caused by spasticity. Both concepts are not the same, but are closely related. Spasticity can affect anyone, from young to old. Sometimes this is congenital, sometimes as a result of an accident or illness. Spasticity is especially common in premature children, approximately 1 in 10 cases.

Recognizing spasticity

With spasticity there is an increase in tension in the muscles. This is especially noticeable during exertion or movement, but also in emotional situations. This does not mean that spasticity does not occur at rest: this also happens, but sometimes less often or less clearly. Spastic paralysis also occurs. The patient cannot perform the movements properly. This is caused by the muscles not working together properly. What we see are rough movements, wrong movements and ‘clumsiness’.

Cause

Spasticity is often congenital and has already developed during pregnancy. A defect in the brain is the cause of this. Things can go wrong, especially during the first three months of pregnancy, during the baby’s development. For example, later in pregnancy an infectious disease can cause damage to the brain. Something can also go wrong during delivery, causing the baby to be temporarily deprived of oxygen. A short moment without oxygen is sometimes enough to cause damage to the brain. The longer the brain is without oxygen, the greater the damage will be.
Another cause is an accident that damages either the brain or the spinal cord. The latter is also called a spinal cord injury. A spinal cord injury can also be caused by a spinal fracture, inflammation of the spinal cord, a tumor or a congenital spina bifida. All forms of spinal cord injury sometimes or often cause spasticity. A stroke can also cause spasticity. In babies, severe jaundice is also found to be the cause.

Semi-lateral spastic paralysis

Half-sided spastic paralysis occurs especially in children and is congenital. In the elderly it is often seen after a stroke. With hemispherical spastic paralysis, only one side is paralyzed and spastic, the other side functions normally. This form of spasticity occurs more often in Little’s syndrome.

Symptoms and treatment

Spasticity is recognizable by gross movements and disturbed motor skills. In addition, muscle cramps occur. Sometimes the limbs are forced into a position (forced city) and sometimes the muscles become completely weak over time. The latter is mainly seen in spinal cord injury.
Spasticity is not always immediately recognizable. Often the first symptoms only appear around the age of six months. The baby should start to hold something for the first time in this phase. What is striking is that the motor skills are not smooth and that the position of the hand is different during grasping. Children often have other conditions in addition to spasticity, such as epilepsy, language delay, general developmental delay, behavioral abnormalities, mental retardation, etc. Such symptoms should always be checked by a pediatrician, especially when multiple symptoms occur and they are not temporary.
The treatment consists of physiotherapy and/or speech therapy. Furthermore, aids can be purchased. It is important to start treatment as early as possible to prevent the symptoms from getting worse. Spasticity cannot always be completely treated, but halting the deterioration is an important step. Many children with spasticity will eventually be able to lead a reasonably normal life, other children will later perform adapted work or in severe cases require guidance. This depends on the degree of spasticity and the treatment: this must be very intensive.
In the elderly, day surgery will sometimes be necessary, especially after a stroke. During this treatment, the main focus will be on remobilizing the patient and working on self-reliance. With half-sided paralysis it is often possible to become independent again. In the case of complete spastic paralysis this is not always possible, but the patient can be taught to use aids. Often the problem in the elderly lies in a longer healing time, both mentally and physically.
A spinal cord injury does not mean that someone will never be able to walk again or will always remain spastic. This partly depends on the damage. Intensive physiotherapy and rehabilitation can achieve very good results.

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