Spasticity

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Diagnosing and Treating Spasticity

Although the symptoms of spasticity often seem obvious, the condition should be evaluated by an expert in neuromuscular disorders to get an accurate diagnosis and treatment plan. When symptoms are mild, expert evaluation is even more important so that treatment is not delayed due to misdiagnosis.

A complete physical examination, including neurological testing, will assess the extent of the spasticity. In addition to the medical and neurological exam, anyone with symptoms of spasticity should be evaluated by a physical therapist to determine exactly which muscles are involved.

Imaging tests may help provide information about the nature and extent of the brain damage causing the spasticity:

Magnetic resonance imaging (MRI) scans produce detailed images of the brain and spine and allow doctors to see abnormalities that may cause spasticity.  These tests are noninvasive and don’t involve X-ray exposure, but they do require time in a scanner to produce tiny slices of images that are then combined into three-dimensional pictures. Sometimes a child will need a special contrast agent in advance to increase the visibility of any abnormality found. Young children often require sedation to keep them still enough to produce clear images.

Treatment Options
There are several forms of treatment for spasticity, and the treatment plan often involves more than one form. Although none of these treatments can provide a cure, they can alleviate symptoms and improve daily life:

Physical therapy is a common therapy for spasticity and includes exercise, stretching, and joint movements to help ease symptoms in the larger muscles.

Occupational therapy focuses on smaller muscle groups than physical therapy and may help alleviate symptoms in the hands to improve the ability to perform daily activities.

Speech therapy can help improve daily life for patients whose spasticity affects their ability to speak.

Casting or bracing a spastic muscle is sometimes recommended to counter the effects of involuntary contractions.

Medications may help loosen the spastic muscles. Medication may be given orally or by injection to affected muscle groups. Medication may also be delivered “intrathecally” by an implanted pump (see Surgery for Spasticity).

Surgical options include implanting a pump that delivers a steady dose of medication called Baclofen or surgery to rebalance the electrical input to the spine from the legs through a procedure called a rhizotomy. (See Surgery for Spasticity.)

It’s important that a treatment plan for spasticity consider all options and include all forms that can provide relief. The multidisciplinary team at the NeuroMotor Disorders Program evaluates patients and offers treatment choices from a range of health specialties. Download our brochure.

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Reviewed by: Jeffrey Greenfield, Ph.D., M.D.
Last reviewed/last updated: January 2015