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

The therapeutic effect of n-dipropylacetate (DPA) is described in 20 patients with cerebral or spinal spasticity. Improvement was ween in 8 out of 11 patients with cerebral spasticity, 3 out of 5 patients with spinal spasticity and 3 out of 4 cases who had sustained perinatal damage. Satisfactory clinical amelioration and improvement in the EEG was observed in myoclonia, particularly of the Unverricht-Lundborg type.
Wien Klin Wochenschr 1976 Dec 10
PMID:[Augmented indication field for Convulex therapy (author's transl)]. 79 50

From a population of 902 adult patients with acquired hemiplegia, thirty-two patients with extensor synergy were chosen for a reconstructive procedure designed to eliminate the need for an orthosis. Three additional patients underwent the procedure to eliminate severe spasticity which precluded orthotic fitting. The operative technique, first described by Mooney and associates, involved lengthening of the tendo achillis and tibialis posterior tendon, multiple toe-flexor tenotomies, and a split transfer of the tibialis anterior tendon. Satisfactory results were recorded for thirty-two patients. The three failures were ascribed to inappropriate selection of patients for surgery.
J Bone Joint Surg Am 1976 Dec
PMID:Oerative treatment of the plantar-flexed inverted foot in adult hemiplegia. 100 58

It is difficult to assess objectively the effectiveness of treating children with cerebral palsy during the first year of life. 50 pupils with cerebral palsy were selected for handicap and intelligence and carefully examined. All children were treated with the neurodevelopmental technique of BOBATH, 22 of them within the first year of life, 28 thereafter. The examination in school age showed differences between the two groups. When treatment is commenced before nine months of age, children with spastic diplegia resulting from premature birth are unlikely to require special schooling for reasons of their physical handicap. After early treatment, patients with severe neuromuscular dysfunction in early life frequently display disturbances of a predominantly ataxic nature when reaching school age. Spasticity appears to respond well and athetosis less favorably to early treatment. More severe brain damage in the early treated children is possibly indicated by the higher incidence of epilepsy. Pupils who were treated early show significantly fewer behavioural disturbances, with the exception of cases where symbiotic neurosis in the mother is present. This is important for the development of the personality and the individual capacity of integration.
Helv Paediatr Acta 1976 Dec
PMID:[Early treatment of cerebral movement disorders: findings among 50 school children]. 101 81

Spastic or hyperreflex bladder dysfunction can cause frequency, urgency, and incontinence. Detrusor activity was inhibited by FES (functional electrical stimulation) applied to the anal sphincter causing decreased bladder spasticity and increased bladder capacity. FES is indicated for incontinence not only because of weakness of the pelvic floor but also because of hyperreflex bladder.
Urology 1975 Dec
PMID:Bladder inhibition with functional electrical stimulation. 110 26

The recurrent inhibition of alpha motoneurons was studied in 8 mentally retarded subjects (age 16-35 years), six of whom also had non-pyramidal or extrapyramidal motor alterations, manifesting as rigid and inflexible voluntary and/or postural movements. Despite a similar degree of mental retardation (Raven spatial general intelligence test), the other 2 cases showed much more modest changes in motor behavior. At rest, recurrent inhibition on soleus motoneurons was normal in all patients. In the 6 cases exhibiting more severe motor abnormality, the changes in Renshaw cell excitability, which occur during postural or voluntary contractions in normal subjects, were not found. This expressed the lack of supraspinal influences on Renshaw cells in these patients. On the other hand, supraspinal modulating influences on Renshaw cells were virtually normal in the remaining 2 patients. The absence of excitability changes of recurrent inhibition to postural or voluntary movements is discussed in relation to the abnormality of motor behavior observed in these patients. In addition, since paralysis of adaptive changes of recurrent inhibition has so far only been described in spastic subjects, the present study demonstrates that the descending pathways, which control recurrent inhibition gain, are different from those which, when damaged, lead to spasticity. Finally, our results indicate that the changes in motor behavior often associated with mental retardation cannot be regarded merely as the consequence of defective motor learning.
Electroencephalogr Clin Neurophysiol 1992 Dec
PMID:Supraspinal influences on recurrent inhibition in humans. Paralysis of descending control of Renshaw cells in patients with mental retardation. 128 61

A prospective, blinded study was done to examine the effects of acute bolus and chronic continuous intrathecal baclofen on genitourinary function in 10 patients with severe spasticity due to spinal cord pathology. Genitourinary function was assessed by symptom questionnaires and urodynamic studies performed after a bolus dose of baclofen and 6 to 12 months after continuous intrathecal baclofen. Results were compared to placebo for acute bolus testing or to pre-continuous intrathecal baclofen values. In all patients with irritative voiding and urge incontinence uninhibited bladder contractions were eliminated. Of 3 patients with an indwelling urethral catheter for incontinence due to detrusor hyperreflexia 1 was converted to intermittent self-catheterization. Whereas bladder capacity, compliance, sensation and voiding pressures were not different after continuous intrathecal baclofen, when a mean of all patients was compiled, a 72% increase in capacity and 16% improvement in compliance were observed in subjects without cervical spinal cord pathology. Detrusor-sphincter dyssynergia was abolished in 40% of the patients. Continuous intrathecal baclofen may represent a novel approach to the management of patients with a neurogenic bladder who have decreased bladder compliance and detrusor hyperreflexia not controlled by oral medications.
J Urol 1992 Dec
PMID:Effects of acute bolus and chronic continuous intrathecal baclofen on genitourinary dysfunction due to spinal cord pathology. 143 19

Continuous intrathecal infusion of the well known antispastic medication baclofen was evaluated in ten consecutive patients. One year after pump implantation the average Ashworth scale for muscle tone decreased, compared with before treatment, 2.32 points (P < 0.0001), reflexes decreased 2.22 points (P < 0.0001) and the spasm score decreased 1.65 points (P < 0.0001). The average dose increased from 92.22 to 290.95 micrograms (P < 0.0001) between the 1st month of treatment and 1 yr of treatment. The dosage for all patients more than doubled (P < 0.0022) between 3 months and 1 yr postimplantation. There was no significant difference for muscle tone, reflexes or spasms at 3 months v 1 yr. Complications were not unusual and included temporary atelectasis, orthostatic hypotension with escalation of baclofen dose, loss of penile erections, postsurgical pseudo-meningoceles, catheter disruptions and exhausted pump reservoirs. One patient suffered a seizure apparently related to a rapid withdrawal from intrathecal baclofen as a result of catheter sequestration. All patients required a period of intensive inpatient rehabilitation to benefit functionally from the decreased motor tone and/or increased voluntary motor control. The procedure is expensive and close follow-up is necessary for assessing efficacy and refilling the pump. Intrathecal baclofen infusion by subcutaneous pump is useful in treating the effects of spinal spasticity resistant to oral medications. However, there appears to be accommodation to intrathecal baclofen necessitating escalating doses to maintain clinical effects.
Am J Phys Med Rehabil 1992 Dec
PMID:Continuous intrathecal baclofen in spinal cord spasticity. A prospective study. 146 69

Soleus H-reflexes were recorded in 10 normal subjects and seven patients with spasticity caused by incomplete spinal cord injury while they pedalled on a stationary bicycle which had been modified to trigger electrical stimuli to the tibial nerve at eight precise points in the pedal cycle. Stimulus strength was adjusted to yield M-waves of constant amplitude at each pedal position. During active pedalling, all normal subjects showed modulation of the H-reflex with the amplitude being increased during the downstroke portion of the pedal cycle and the reflex suppressed or absent during the upstroke. This modulation was not present during passive pedalling, with the experimenter cranking the pedals by hand, or when the pedals were locked at each of the eight positions. In five of the seven patients with spasticity, there was reduced or absent modulation of the H-reflex during active pedalling and the reflex remained large during pedal upstroke. It is concluded that descending motor commands that produce patterned voluntary activity during pedalling normally cause cyclical gating of spinal reflexes by either presynaptic or postsynaptic inhibitory mechanisms. Loss of supraspinal control over these spinal inhibitory systems could result in failure to produce appropriate suppression of reflexes during patterned voluntary movements such as pedalling or walking, and may be an important factor contributing to the functional disability in spasticity.
J Neurol Neurosurg Psychiatry 1992 Dec
PMID:Modulation of the soleus H-reflex during pedalling in normal humans and in patients with spinal spasticity. 147 94

The purpose of this investigation was to evaluate the alterations of flexor reflex parameters in spasticity and the possibilities to take advantage of them as a method for assessment of common interneurone activity. Clinical and electromyographical examinations were performed on 120 patients with spastic hemiparesis after stroke. The flexor reflex was obtained after supramaximal electrostimulation of the tibial nerve behind the ankle. The stimulus consisted of 50 msec train of 1 msec duration pulses given at 100 Hz. The reflex activity was recorded from the tibialis anterior muscle. As all patients were with hemiparesis the healthy side was used as a control. The patients were subdivided into four groups, each treated with different myorelaxants (Baclofen, Sirdalud, Myolastan and electroacupuncture). After about 25 days treatment the clinical and electromyographic examinations were repeated. The flexor reflex was recorded with two clearly distinguishable responses on the healthy, as well as on the spastic side. On the spastic side a reflex with prolonged latencies and durations, as well as with decreased amplitudes and thresholds of both reflex responses was found. On the spastic side the first reflex response had higher threshold than the second one, while on the healthy side it was vice versa. Moderate correlations were found between most of the reflex parameters. No correlations were found between the reflex parameters and the degree of spasticity. Only after Baclofen treatment all reflex parameters tended to normalized. After treatment with Myolastan, Sirdalud and electroacupuncture only the second response's duration shortened. In conclusion the flexor reflex is a sensitive method for assessment of altered common interneurone activity in spasticity.(ABSTRACT TRUNCATED AT 250 WORDS)
Electromyogr Clin Neurophysiol 1992 Dec
PMID:Flexor reflex for assessment of common interneurone activity in spasticity. 149 77

Our knowledge of the specific root innervation of skeletal muscles is derived from accumulated clinical experience. While performing selective posterior rhizotomy for treatment of spasticity in children with cerebral palsy, we made direct electrophysiologic measurement of the root innervation of the lower extremity. We stimulated ventral roots from L2 to S2 while recording from all muscles simultaneously. The size of the evoked compound muscle action potential was used as an indication of the amount of innervation derived from stimulation of a given spinal root. We found the major root innervation for the 8 muscles studied to be: adductor longus, vastus medialis, and vastus lateralis, L3; tibialis anterior; L4; peroneus longus, L5; and medial gastrocnemius, lateral gastrocnemius, and gluteus maximus, S1. In general, each muscle received innervation from 3 or more roots. Prefixed or postfixed innervation patterns were found in 27.9% of legs examined, and there was asymmetry of innervation in 29.8%. We conclude that the segmental innervation of lower extremity muscles is broader than previously thought. Anomalous innervation occurs so frequently that caution should be used in attributing any pattern of clinical or EMG findings to a specific spinal level.
Muscle Nerve 1991 Dec
PMID:Electrophysiologic mapping of the segmental anatomy of the muscles of the lower extremity. 149 14


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