Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Many of the disturbances resulting from dysregulations in the autonomous nervous system of children with cerebral palsy are rarely discussed in the doctor's praxis. Nevertheless, they are causes of trouble and worry for the parents. For this reason we started an inquiry into this matter. Questionnaires were sent to the parents of 452 C.P. patients. 374 were answered with sufficient care. The following factors were evaluated: sleep, bladder and bowel activity, temperature regulation, vomiting, sweating, blood circulation, growth. The C.P. children were compared to their own siblings especially to the next younger ones. The diagnoses were as follows: Spastic tetraplegia 197 patients. Spastic hemiplegia 44 patients, Athetosis 33 patients, Mixed cases of spasticity and athetosis 82 patients, Other 15 patients. The degrees of handicap in terms of motor development were: severe (unability to sit unsupported) 166 cases, moderate (unability to kneel or walk unsupported) 118 cases, mild (ability to kneel and/or walk unsupported) 87 cases. Summarized, the statements of the parents gave the following results: sleep disturbances: 169 cases (46%), constipation: 145 cases (39%), tendency towards temperature dysregulation: 112 cases (30%) , tendency towards increased vomiting: 91 cases (25%), sweating increased or decreased: 110 cases (30%), irregular and frequent voiding of bladder: 92 cases (25%), unstable regulation of blood circulation: 101 cases (27%), cold skin: 264 cases (71%), body-length deficit: 119 cases (32%), low-weight: 177 cases (48%), feet too small for age: 252 cases (68%). Results are related to diagnosis and severeness of handicap. In addition, it is discussed, whether there are relations between several of the investigated factors. The influence of the patients sex is discussed.
 ...
PMID:[Vegetative disorders in children with cerebral palsy. Results of an inquiry of parents]. 97 69

Diconium bromide, 2-(3,4-dichloroanilino)-quinolizinium bromide, a potent antispasmodic in the lower bowel of the dog, was found in the present study to exert gastric acid-antisecretory and antiulcerogenic activities in the rat stomach. These effects were demonstrated by means of short- and long-term pyloric ligation, acetylsalicylic acid (ASA)-induced ulcerogenesis, and cold-and-restraint stress studies. A reduction of gastric acid concentration by the drug was probably responsible for the decrease in the degree of ulceration and hemorrhagic lesion formation. The drug's inhibition of stress hemorrhagic lesions may be related to an effect both on gastric HCl secretion and on the vasculature in the glabdular mucosa. The delay of gastric emptying by diclonium bromide results from its known antispasmodic or smooth-muscle depressant action. The toxicity of diclonium bromide, perorally, was low in rats and overt signs of drug effect were not evident until toxic doses were administered. It is concluded that diclonium bromide may represent a useful non-anticholinergic drug effective in treating both peptic ulcers and spasticity of the colon (irritable-colon syndrome) in man.
 ...
PMID:Some aspects in the pharmacology of diclonium bromide (2-(3,4-dicholoroanilino)quinolizinium bromide). Part II: Gastric acid-antisecretory and antiulcerogenic actions. 98 24

The functional impairment due to spasticity must be carefully assessed before any treatment is considered. Therapeutic intervention is best individualized to a particular patient. Basic principles of treatment to ameliorate spastic hypertonia are: 1) avoid noxious stimuli and 2) provide frequent range of motion. Therapeutic exercise, cold or topical anesthesia may decrease reflex activity for short periods of time in order to facilitate minimal motor function. Casting and splinting techniques are extremely valuable to extend joint range diminished by hypertonicity. Baclofen, diazepam and dantrolene remain the three most commonly used pharmacologic agents in the treatment of spastic hypertonia. Baclofen is generally the drug of choice for spinal cord types of spasticity, while sodium dantrolene is the only agent which acts directly on muscle tissue. Phenytoin with chlorpromazine may be potentially useful if sedation does not limit their use. Tizanidine and ketazolam, not yet available in the United States, may be significant additions to the pharmacologic armamentarium. Intrathecal administration of antispastic medications allows high concentrations of drug near the site of action, which limits side effects. This form of treatment is the most exciting recent development in the treatment of spastic hypertonia. Peripheral electrical stimulation may have limited use in diminishing tone and facilitating paretic muscles. Dorsal column stimulation via electrodes within the spinal column was initially hailed as a therapeutic advance, but has subsequently been shown to be minimally effective. Phenol injections provide a valuable transition between short-term and long-term treatments and offer remediation of hypertonia in selected muscle groups. Tenotomies and tendon transfers offer significant benefit in carefully chosen patients.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Management of spasticity. 328 46

The local application of cold has been used to decrease spasticity and facilitate neuromuscular function, but previous attempts to identify its effect on the stretch reflex have not been entirely successful. We examined the effects of cold on the Hoffmann (H) reflex and on the tendon tap (T) reflex in 16 subjects. A series of H/M recruitment curves and T-reflexes were recorded via surface EMG electrodes before and during cooling of the triceps surae. Skin and intramuscular temperatures were recorded with average decreases of 18.4C and 12.1C, respectively. Peak-to-peak amplitude of the M, H, and T compound action potentials (CAPs) was measured. In all cases, the amplitude of the maximal M-wave decreased (p less than 0.001) in response to cooling. These changes in the recording of CAPs should be considered when cooling experiments result in alterations in H or T waveforms. When using the M-wave as a covariant in our analysis, there were no significant changes in the H-reflex amplitude; the height of CAPs elicited by T decreased (p = 0.025). Our findings do not support earlier claims that simple cooling facilitates the excitatory alpha motoneuron pool as measured by the H-reflex; we do confirm that muscle spindle activity, as measured by the T-reflex, is decreased by muscle cooling.
 ...
PMID:Effect of cooling on H- and T-reflexes in normal subjects. 361 11

Muscle spasm can be reduced by heat as well as by therapeutic cold. However, in upper motor neuron lesions, cold is more effective in reducing the spasticity. This effect lasts long enough to be of therapeutic value. Water immersion supports the reduction of muscle tone. Pain may be reduced by both thermal stimuli. The pain threshold seems to be elevated by the direct effect of both heat and cold on the free nerve endings and the pain-killing fibers. The tendency to bleed is increased with heat application and decreased with cold therapy. Edema resulting from trauma is increased with heat, and decreased in its development by cold application. Joint stiffness is decreased with heat application and increased with cold application. Water immersion removes weight from the joints and facilitates mobility.
 ...
PMID:[Thermo- and hydrotherapy]. 787 3

Two hundred forty-seven patients with spinal cord injuries living in Hokkaido, the northern part of Japan, were mailed a questionnaire relating to winter outdoor activities. One hundred eight patients responded to the questionnaire, 98 males and 10 females, with ages ranging from 30 to 79 (mean, 53.3) yr. Injury levels of patients were: cervical in 23 patients, thoracic and thoracolumbar in 47, and lumbar in 38. All respondents were unable to walk independently because of quadriplegia or paraplegia. Approximately 90 percent of respondents found it necessary to go outside during the winter season. Eighty-five percent were outside during the coldest period. The most common reasons for outdoor activities were shopping and routine doctor's appointments. The main method of ambulating outside was a manual and/or electrically operated wheelchair, sometimes in conjunction with an automobile. However, there were many problems reported in using wheelchairs; for example, wheels and casters were very slippery on the snow and ice, casters were easily buried in the snow, and wheelchair rims were very cold to handle. It was also pointed out that exposure to cold weather induced physical problems such as muscle spasticity, pain, and numbness of lower extremities. This survey revealed that spinal cord-injured patients would benefit from a wheelchair specifically designed for winter conditions.
 ...
PMID:Outdoor winter activities of spinal cord-injured patients. With special reference to outdoor mobility. 853 83

We report a patient with craniovertebral anomaly leading to cervical cord compression who presented with disabling postural hypotension. A 60-year-old electrician presented with progressive weakness of the upper and lower limbs, which had started 7 years previously. He had difficulty in holding urine for the previous year and had blacked out on standing for the past 3 months. He had upper limb wasting and lower limb spasticity, with impaired joint position sense. Autonomic dysfunctions included postural hypotension, absence of sinus arrhythmia, impaired Valsalva ratio, and lack of increase in blood pressure on cold immersion and isometric contraction. Cervical spine radiograph and magnetic resonance imaging revealed atlantoaxial dislocation, Klippel-Feil syndrome and osteophytes, resulting in cord compression at C2-C4. Partial and selective damage to the descending autonomic fibres may be responsible for postural hypotension in this patient.
 ...
PMID:Postural hypotension in a patient with cervical myelopathy due to craniovertebral anomaly. 937 68

This study examined the extent to which a battery of tests could detect a reduction of plantarflexor spasticity resulting from cryotherapy. The tests included a traditional qualitative spasticity scale, three potential quantitative spasticity measures and a measure of voluntary ankle muscle function. Twenty-six adult traumatic-brain-injured subjects were examined; these included 22 males and 4 females. The mean age was 28.15 years (range: 18-57, SD 10.78). The five tests were performed in random sequence on both ankles of each subject, before and after a 20 minute cold pack application to the calf. Tests were: modified Ashworth scale (MAS) scoring; H-reflex testing with and without dorsiflexor contraction (Hdf/Hctrl ratio); H-reflex testing with and without Achilles tendon vibration (Hvib/Hctrl ratio); reflex threshold angle (RTA) and timed toe tapping (TIT). Cryotherapy resulted in lowered MAS scores consistent with a reduction in spasticity. Doubly multivariate repeated measures ANOVA revealed a significant difference (F = 24.16, P < 0.001) in test scores between the pre- and post-cryotherapy test batteries. Significant pre- and post-cryotherapy differences (P < or = 0.03) for all dependent measures contributed to the main effect for cryotherapy. However, among the potential quantitative measures of spasticity only the RTA test demonstrated appropriate sensitivity to the reduction in spasticity. In spite of spasticity reduction, TIT performance was impaired following muscle cooling. Failure of the H-reflex ratios to show a reduction consistent with reduced spasticity was attributed to competing alpha and gamma motoneuron effects resulting from peripheral cooling.
 ...
PMID:Sensitivity of qualitative and quantitative spasticity measures to clinical treatment with cryotherapy. 1130 60

This article reviews various physical modalities that have been used in spastic hypertonia, particularly superficial heat and cold, diathermies (ultrasound, microwave, and short-wave irradiation), electrical stimulation (transcutaneous electrical nerve stimulation), implanted spinal stimulation (rectal stimulation), and massage (deep friction, superficial contact). The duration of the effects of most physical therapies is relatively short (e.g., cooling, heating, and massage), which often may limit their application to immediate prestretch or pre-exercise periods. The potential capacity of ultrasound therapy to improve the efficacy of chronic stretch in lengthening muscle may be a promising option. The neurodestructive potential of high intensity microwave for the personnel involved and controlled evidence of its value is required before this modality can be recommended in spasticity. Overall, controlled, double-blind studies are mandated to evaluate the long-term impact of repeated use of these short-term modalities on function and recovery in patients with spasticity.
 ...
PMID:Physical modalities other than stretch in spastic hypertonia. 1172 65

There are a number of physiological means of relaxing spasticity, including active resistive exercise, cold hydrotherapy, heat, electrical stimulation of antagonistic muscles, passive stretch in diagonal movement patterns, and the Von Bechterew reflex. Although none of them will cure spasticity, temporary relaxation may permit a patient to achieve better functioning of an affected joint. The choice of procedure will depend on the nature of the lesion and the muscular distribution of the spasticity.
 ...
PMID:Spasticity; its nature and treatment. 1315 Feb


1 2 3 Next >>