DESCRIPTION
Any number of different issues in the brain or spinal cord can cause spasticity. This is because our muscles are controlled by nerves. Nerves connect muscles to the spinal cord and brain. A problem at any point along a nerve pathway can lead to spasticity. Spasticity is a sign of an underlying problem in the nervous system.
Children with spasticity may have:
- Arms or legs that are difficult to move due to muscle tightness
- More muscle resistance to stretching and movement
SIGNS AND SYMPTOMS
Signs
There are several signs of spasticity:
Resistance
Range
Spasticity can appear:
- Shortly after birth
- Later in life, if a child has an injury to the nervous system
Symptoms
Possible symptoms include:
- Muscle stiffness
- Pain
- Muscle spasms
- Clonus, or repeated muscle contractions
- Scissoring (involuntary crossing) of the legs
- Contractures, or fixed joints that cannot be moved
- Difficulty moving the affected limbs
- Difficulty walking
- Changes in sensation
A child may have other symptoms, too, depending on the underlying cause of the spasticity.
For example:
Stroke as underlying cause
Some children have spasticity resulting from a stroke that occurred prior to birth. Depending on where the stroke was in the brain, it may cause spasticity as well as other symptoms. For instance, it may cause developmental delays or muscle weakness on one side of the body. It may cause learning difficulties.
INVESTIGATIONS
Clinical Exams
A diagnosis involves examining the child’s joints and muscles. A child with suspected spasticity will be referred to a child neurologist and a rehabilitation specialist.
The neurologist will:
- Take a complete health history, including family history, birth history, and medical/surgical history
- Perform a physical exam
- Recommend any further testing needed: neuroimaging, laboratory studies, genetic studies, etc.
- Refer to other specialists as necessary
The rehabilitation specialist will:
- Perform an exam: assess tone, range of movement, posture and recommend therapies
- Recommend medications for tone management
Imaging Studies
Doctors may order pictures of the brain and spinal cord. The pictures can show if there has been damage to these areas, causing the spasticity. The most likely type of imaging they order is magnetic resonance imaging (MRI).
Blood tests
Depending on your child’s health history and their other symptoms, the doctor may order blood tests to look for possible causes. They may ask for tests to look for:
- Infection
- Metabolic abnormalities
- Genetic abnormalities
TREATMENT AND THERAPIES
A team of therapists work with children with spasticity. They can help make progress with:
- Developmental milestones
- Strength
- Muscle tone
- Range of motion
Possible treatments include:
Medications
Splinting, casting, or bracing
Botox injections
Resources
ORGANIZATIONS/GROUPS
Cerebral Palsy Research Network
The mission of the Cerebral Palsy Research Network (CP Research Network) is to optimize the lifelong health and wellness of people with cerebral palsy and their families through high quality research, education, and community programming. The CP Research Network is the largest and most comprehensive collaboration of hospitals and community members working together to improve health outcomes for people with CP. Through a search for Spasticity on their website, you will find articles, videos, and research studies.
Spastic Paraplegia Foundation
The Spastic Paraplegia Foundation, Inc. (SPF) is the only organization in the Americas dedicated to finding a cure for Hereditary Spastic Paraplegia (HSP) and Primary Lateral Sclerosis (PLS). They are a not-for-profit voluntary organization. The primary goal has been to raise money to find a cure. Since their creation in 2002, they have raised and funded over $10 million in research grants. SPF hosts a private Facebook group, Spastic Paraplegia Foundation, Inc #HSPandPLS
PUBLICATIONS
The Cerebral Palsy Tool Kit
Cerebral Palsy Research Network offers The Cerebral Palsy Tool Kit: From Diagnosis to Understanding for parents and caregivers who have a child with a Cerebral Palsy diagnosis. This must-have guide is available in English, Portuguese, and Spanish and available to download for free. You may also purchase a printed copy.
Wellbeing for Parents and Caregivers
Cerebral Palsy Research Network offers Wellbeing for Parents and Caregivers, a supportive resource guide for parents and caregivers who are raising a child, adolescent or young adult with Cerebral Palsy or another disability. Available to download for free.
Child Neurology Foundation (CNF) solicits resources from the community to be included on this webpage through an application process. CNF reserves the right to remove entities at any time if information is deemed inappropriate or inconsistent with the mission, vision, and values of CNF.