Paralysis Resource Guide - (Page 97) HEALTH MANAGEMENT SPASTICITY Spasticity is a side effect of paralysis that varies from mild muscle stiffness to severe, uncontrollable leg movements. Generally, doctors now call conditions of extreme muscle tension spastic hypertonia (SH). It may occur in association with spinal cord injury, multiple sclerosis, cerebral palsy, anoxic brain damage, brain trauma, severe head injury, some metabolic diseases such as adrenoleukodystrophy, and phenylketonuria. Symptoms may include increased muscle tone, rapid muscle contractions, exaggerated deep tendon reflexes, muscle spasms, scissoring (involuntary crossing of the legs) and fixed joints. When individuals are first injured, their muscles are weak and flexible because of what’s called spinal shock: The body’s reflexes are absent below the level of injury; this condition usually lasts for a few weeks or several months. Once the spinal shock is over, reflex activity returns. Spasticity is usually caused by damage to the portion of the brain or spinal cord that controls voluntary movement. Since the normal flow of nerve messages to below the level of injury is interrupted, those messages may not reach the reflex center of the brain. The spinal cord then attempts to moderate the body’s response. Because the spinal cord is not as efficient as the brain, the signals that are sent back to the site of the sensation are often over-exaggerated in an overactive muscle response or spastic hypertonia: an uncontrollable “jerking” movement, stiffening or straightening of muscles, shock-like contractions of a muscle or group of muscles, and abnormal tone in the muscles. Most individuals with SCI have some spasms. Persons with cervical injuries and those with incomplete injuries are more likely than those with paraplegia and/or complete injuries to experience SH. The most common muscles that spasm are those that bend the elbow (flexor) or extend the leg (extensor). These reflexes usually occur as a result of an automatic response to painful sensations. While spasticity can interfere with rehabilitation or daily living activities, it is not always a bad thing. Some people use their spasms for function, to empty their bladders, to transfer or to dress. Others use SH to keep their muscles toned and improve 97
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