Re: OT Muscle spasm/leg stiffness

[Guest guest]

Thanks for this info, ; fortunately I do not suffer from

spasticity very much, but I always like to be more informed, and this

has helped me get a better understanding of what exactly spasticity in

MS is.

Eliza

On Dec 10, 2005, at 1:43 PM, wrote:

> Hope this is of some help:

> <snip

> Muscle stiffness associated with MS is " spasticity " - an increase in

> muscle tone that can interfere with normal movement of the affected

> limb even though the strength of that limb might be normal. This

> increased muscle tone is caused by a dysregulation of nerve impulses

> in the spinal cord, resulting in too much stimulation in some muscles

> and too little in others. Spasticity tends to occur most frequently

> in postural muscles (those that enable us to stand upright),

> including muscles in the calf, thigh, groin, buttock, and

> occasionally the back. Spasticity can also occur in the arms. Very

> mild spasticity can sometimes be managed with appropriate stretching

> and range of motion exercises.

>

> If exercises alone are too uncomfortable or do not provide adequate

> relief and mobility, antispasticity medications may be used. A

> variety of medications are available for this purpose, including

> baclofen (Lioresal®), tizanidine (Zanaflex®), clonazepam (Klonopin®),

> diazepam (Valium®), and dantrolene (Dantrium®). Your physician will

> select the particular medication best suited for your needs; baclofen

> is the drug most commonly used. The correct dosage of baclofen will

> differ from one individual to another. The goal of treatment is to

> find the dosage level that provides adequate muscle relaxation

> without producing excessive fatigue or weakness. Tizanidine has been

> shown to relieve spasticity without causing muscle weakness but is

> often sedating.

>

> Occasionally, people with MS-related spasticity develop flexor or

> extensor spasms. These spasms, which typically last two or three

> seconds, are disinhibited (hyperactive) spinal reflexes that can

> occur in response to the slightest of noxious stimuli (e.g., the

> rubbing of bed sheets against the foot during sleep). Flexor spasms

> cause both legs to pull upward into a clenched position, while

> extensor spasms cause the legs to straighten into the stiff, extended

> position. These uncontrolled spasms can be sufficiently intense and

> sudden to propel the person out of his or her chair. Baclofen

> (Lioresal®), gabapentin (Neurontin®), diazepam (Valium®), clonazepam

> (Klonopin®), and tizanidine (Zanaflex®) are the medications of choice

> for the management of this problem.

>

> In the case of severe spasticity that cannot be managed comfortably

> or effectively with oral baclofen (tablets), a pump can be surgically

> implanted in the abdomen to automatically administer low doses of

> liquid baclofen directly into the spinal cord. The pump's usefulness

> stems from its ability to reduce spasticity with a much lower dose of

> medication, thus eliminating the side effects (e.g., severe

> drowsiness, dizziness, weakness, or nausea) that can occur with

> higher doses of baclofen.

>

> In some instances of spasticity, Botox (made from botulinum toxin)

> may be used to block a nerve's function. The Botox is injected into

> the affected muscle at the point where the nerve enters the muscle,

> and prevents the nerve from exciting the muscle to contract. Botox,

> which can be administered by the neurologist, may require repetitive

> injections to achieve sustained blockage of the nerve. It is best

> used for focal spasticity in small muscles like those of the upper

> limbs.

>

> Severe spasticity that does not respond to medications, or for which

> Botox is not suitable, may also be treated with a procedure called a

> nerve block or motor point block. An injection of phenol into the

> affected nerve chemically damages the nerve and interferes with its

> function for up to three months. This temporary destruction of the

> nerve prevents the affected muscle from contracting and allows the

> person to feel more comfortable. The nerve block may also improve

> gait and mobility. The injections of phenol are usually given by a

> physiatrist or anesthesiologist using an JEMG to pinpoint the

> location of the nerve.

>

> On rare occasions, surgery is required to cut one particular nerve to

> the affected muscle without endangering other nerves that are in

> close proximity. This surgical procedure is permanent 1 and

> irreversible. Fortunately, the recent availability of the baclofen

> pump has greatly reduced the need for nerve blocks or surgery to

> reduce spasticity.

>

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[Guest guest]

Your welcome. I don't suffer from spasticity myself. Just the toes on

one foot. They bend backwards ;o0 Ouch! My brain must be on hold

because I swear someone had spasticity. Lol!

Take Care

> Thanks for this info, ; fortunately I do not suffer from

> spasticity very much, but I always like to be more informed, and this

> has helped me get a better understanding of what exactly spasticity

in

> MS is.

>

>