Hypertonicity vs spasticity: Difference between revisions

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Hypertonicity or spastic dystonia
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'''Original Editors '''- [[User:Saeed Dokhnan|Saeed Dokhnan]]


&nbsp;1-hypertonicity or spastic dystonia is a continues increase in the muscle tension without regarding to the movement and is dependent upon afferent information from feedback following movements of stretch , decorticat and decerbrate rigidity are a form of spastic dystonia, spastic dystonia is considered to be a form of sustained efferent muscular hyperactivity , dependent on continues supraspinal derive to the alpha motor neuron [[Image:Decorticate.jpg]]<br>  
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= <br> =
== Spastic Dystonia  ==
Spastic Dystonia or hypertonicity is the inability to relax a muscle leading to a spontaneous tonic contraction.<ref name=":0">Marinelli L, Currà A, Trompetto C, Capello E, Serrati C, Fattapposta F, et al. [https://pubmed.ncbi.nlm.nih.gov/28985544/ Spasticity and spastic dystonia: the two faces of velocity-dependent hypertonia. J Electromyogr Kinesiol] [Internet]. 2017;37:84–9. Available from: </ref>Spastic dystonia is most noticeable in humans in the upper limb, where it contributes to the so-called hemiparetic posture, especially in subjects with stroke or cerebral palsy. During standing and gait, the subject may adopt a posture with plantarflexion and/or inversion at the ankle, toe flexion, pronounced extension at the knee, and associated flexion at the elbow, which is an aggravated expression of spastic dystonia. <ref name=":0" />


= Spasticity  =
=== Muscle Tone ===


- spasticity is a velocity dependent increase in muscle tone in regarding to passive movement  
* Tone is the resistance of muscles to passive [[Stretching|stretch]] or elongation, basically the amount of tension a muscle has at rest.
* Normal tone is high enough to resist the effects of gravity in both posture and movement yet low enough to allow freedom of movement<ref>[https://www.pediatricservices.com/answers/005-hypertonia.htm Hypertonia, clonus , & spasticity] Pediatric Services </ref>
* [[Hypertonia Assessment Tool|Hypertonia]] is resistance to passive movement, it is not dependent on velocity, can be with or without spasticity.
* Spasticity is an increase in resistance to sudden , passive movement and is '''velocity dependent'''. The faster the passive movement the stronger the resistance. <ref name=":1" />It is also a term that is often used interchangeably with hypertonia.However, is a particular type of hypertonia in which the muscles' spasms are increased by movement.
* Spasticity is considered to be a form of sustained efferent muscular hyperactivity, dependent on the continuous supraspinal drive to the alpha motor neuron.<ref name=":1">Clinical evaluation and management of spasticity,  Jeffery et. al.2002</ref>


pyramidal&nbsp;tract lesions
=== Forms of Spastic Dystonia ===
[[Image:Decorticate.jpg|right|300px]]Decorticate and decerebrate [[rigidity]] are a form of spastic dystonia:
* '''Decorticate posture''' is a sign of damage to the nerve pathway in the [[midbrain]], which is between the brain and [[Spinal cord anatomy|spinal cord]]. The midbrain controls motor movement. Serious condition but not as severe as the below.
* '''Decerebrate posture''' is an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward. The muscles are tightened and held rigidly. This type of posturing usually means there has been severe damage to the [[Brain Anatomy|brain]]<ref>M S Hershey Medical centre. [http://pennstatehershey.adam.com/content.aspx?productid=117&pid=1&gid=003300 Multimedia encyclopedia] </ref>.


-pyramidal tract injury doesn't give raise to spasticity the main symptoms are weakness and loss of dexterity which is greater in distal than in the proximal muscles
<br>


&nbsp;- pyramidal tract is the system which balance the muscle tone.  
{| width="400" cellspacing="1" cellpadding="1" border="0" align="center"
|-
| {{#ev:youtube|YNnwf_XbRac|300}}<ref>AriseandShineTherapy. What is Muscle Tone?. Available from: http://www.youtube.com/watch?v=YNnwf_XbRac [last accessed 29/08/16] </ref>
|}


== neural component of spasticity:&nbsp; ==
== Spasticity ==


1-Dorsoreticulospinal tract (DRT)&nbsp;: Has inhibitory effect on MRT &amp;VST
[[Spasticity]] is a velocity-dependent increase in muscle tone in response to passive movement. [[Extrapyramidal and Pyramidal Tracts|Pyramidal]] tract injury doesn't give rise to spasticity. Rather, the main symptoms are weakness and loss of dexterity which is greater in distal than in the proximal muscles. The pyramidal tract is the system which balances muscle tone.


2-medial reticulospinal tract (MRT) &amp;
<br>


3-vestibulospinal tract ( VST ):  
{| width="400" cellspacing="1" cellpadding="1" border="0" align="center"
|-
| {{#ev:youtube|c-CV6dYNXsw|300}}<ref>brezzyana4's channel. Spastic Diplegia (Cerebral Palsy) 17 months old. Available from: http://www.youtube.com/watch?v=c-CV6dYNXsw [last accessed 29/08/16] </ref>
|}


-they have facilitatory effect on the extensor tone,
=== Neural Component of Spasticity  ===


- all the three systems are though to inhibit flexor reflex afferents responsible for flexor spasm
#Dorsoreticulospinal tract (DRT) - has an inhibitory effect on MRT and VST
#[[Reticulospinal Tract|Medial reticulospinal tract]] (MRT) and [[Vestibulospinal Tract|Vestibulospinal tract]] (VST) - have a facilitatory effect on extensor tone.


= References  =
All three systems are thought to inhibit flexor reflex afferents responsible for flexor spasm.


<references />
{| width="400" cellspacing="1" cellpadding="1" border="0" align="center"
|-
| {{#ev:youtube|nann4fCB6HQ|300}}<ref>Steffan Rasmussen. The Pathophysiology of Spasticity - Dystonia and its Difference From Spasticity [3/8]. Available from: http://www.youtube.com/watch?v=nann4fCB6HQ [last accessed 29/08/16] </ref>
| {{#ev:youtube|THPdi5KSVVk|300}}<ref>Steffan Rasmussen. The Pathophysiology of Spasticity - What Determine Muscle Tone and what Causes Spasticity [4/8]. Available from: http://www.youtube.com/watch?v=THPdi5KSVVk [last accessed 29/08/16] </ref>
|}
 
== References  ==
 
<references />  
 
[[Category:Cerebral_Palsy]]
[[Category:Neurology]]
[[Category:Neurological - Conditions]]

Latest revision as of 17:17, 28 October 2023

Original Editors - Saeed Dokhnan

Top Contributors - Saeed Dokhnan, Laura Ritchie, Lucinda hampton, Admin, Aya Alhindi, Evan Thomas, Scott Buxton, Kate Sampson and Kim Jackson

Spastic Dystonia[edit | edit source]

Spastic Dystonia or hypertonicity is the inability to relax a muscle leading to a spontaneous tonic contraction.[1]Spastic dystonia is most noticeable in humans in the upper limb, where it contributes to the so-called hemiparetic posture, especially in subjects with stroke or cerebral palsy. During standing and gait, the subject may adopt a posture with plantarflexion and/or inversion at the ankle, toe flexion, pronounced extension at the knee, and associated flexion at the elbow, which is an aggravated expression of spastic dystonia. [1]

Muscle Tone[edit | edit source]

  • Tone is the resistance of muscles to passive stretch or elongation, basically the amount of tension a muscle has at rest.
  • Normal tone is high enough to resist the effects of gravity in both posture and movement yet low enough to allow freedom of movement[2]
  • Hypertonia is resistance to passive movement, it is not dependent on velocity, can be with or without spasticity.
  • Spasticity is an increase in resistance to sudden , passive movement and is velocity dependent. The faster the passive movement the stronger the resistance. [3]It is also a term that is often used interchangeably with hypertonia.However, is a particular type of hypertonia in which the muscles' spasms are increased by movement.
  • Spasticity is considered to be a form of sustained efferent muscular hyperactivity, dependent on the continuous supraspinal drive to the alpha motor neuron.[3]

Forms of Spastic Dystonia[edit | edit source]

Decorticate.jpg

Decorticate and decerebrate rigidity are a form of spastic dystonia:

  • Decorticate posture is a sign of damage to the nerve pathway in the midbrain, which is between the brain and spinal cord. The midbrain controls motor movement. Serious condition but not as severe as the below.
  • Decerebrate posture is an abnormal body posture that involves the arms and legs being held straight out, the toes being pointed downward, and the head and neck being arched backward. The muscles are tightened and held rigidly. This type of posturing usually means there has been severe damage to the brain[4].


[5]

Spasticity[edit | edit source]

Spasticity is a velocity-dependent increase in muscle tone in response to passive movement. Pyramidal tract injury doesn't give rise to spasticity. Rather, the main symptoms are weakness and loss of dexterity which is greater in distal than in the proximal muscles. The pyramidal tract is the system which balances muscle tone.


[6]

Neural Component of Spasticity[edit | edit source]

  1. Dorsoreticulospinal tract (DRT) - has an inhibitory effect on MRT and VST
  2. Medial reticulospinal tract (MRT) and Vestibulospinal tract (VST) - have a facilitatory effect on extensor tone.

All three systems are thought to inhibit flexor reflex afferents responsible for flexor spasm.

[7]
[8]

References[edit | edit source]

  1. ↑ 1.0 1.1 Marinelli L, Currà A, Trompetto C, Capello E, Serrati C, Fattapposta F, et al. Spasticity and spastic dystonia: the two faces of velocity-dependent hypertonia. J Electromyogr Kinesiol [Internet]. 2017;37:84–9. Available from:
  2. ↑ Hypertonia, clonus , & spasticity Pediatric Services
  3. ↑ 3.0 3.1 Clinical evaluation and management of spasticity, Jeffery et. al.2002
  4. ↑ M S Hershey Medical centre. Multimedia encyclopedia
  5. ↑ AriseandShineTherapy. What is Muscle Tone?. Available from: http://www.youtube.com/watch?v=YNnwf_XbRac [last accessed 29/08/16]
  6. ↑ brezzyana4's channel. Spastic Diplegia (Cerebral Palsy) 17 months old. Available from: http://www.youtube.com/watch?v=c-CV6dYNXsw [last accessed 29/08/16]
  7. ↑ Steffan Rasmussen. The Pathophysiology of Spasticity - Dystonia and its Difference From Spasticity [3/8]. Available from: http://www.youtube.com/watch?v=nann4fCB6HQ [last accessed 29/08/16]
  8. ↑ Steffan Rasmussen. The Pathophysiology of Spasticity - What Determine Muscle Tone and what Causes Spasticity [4/8]. Available from: http://www.youtube.com/watch?v=THPdi5KSVVk [last accessed 29/08/16]
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