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Spasticity

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In this article

Symptoms

  • Paroxysmal tonic spasms (flexor or extensor): can be painful or painless, most commonly occurring as a chronic symptom of long-standing spasticity.
  • Sustained increase in muscle tone

Notes:

  • Cold weather is one of the most common precipitating factors for worsening spasticity.
  • Spasticity can also be worsened by noxious stimuli including full bladder, full bowel, pressure sores and pain.
  • Some degree of spasticity may be required to support weakened extremities and promote functional mobility.

Treatments

Spasticity can range from relatively mild to quite severe, and treatment is approached in a step-wise fashion

  • Rehabilitative PT: stretching, gait assessment, and balance training, if needed
  • Oral medications: baclofen, tizanidine, dantrolene, clonazepam, diazepam
  • Intrathecal baclofen pump
  • onabotulinumtoxinA (.pdf) injections into individual muscles (FDA-approved for upper limb spasticity)

Psychosocial Implication

  • Spasticity can increase fatigue and interfere with functioning at home and at work
  • Spasticity can interfere with sexual activity and comfort
  • Oral medications may increase fatigue and weakness
  • Surgical implantation of pump in abdomen can be frightening

Resources for clinicians

Resources for patients

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