Pediatric Movement Disorders

Pediatric Movement Disorders - Spasticity

Description

Spasticity is a velocity-dependent increase in resistance to passive movement of a limb. This means that if you try to move the child's arm or leg, resistance increases as the speed of the movement is increased. In some cases, the rapid increase in resistance leads to a "catch" as the limb is moved, with a subsequent "release" of the resistance once the limb stops moving. Spasticity is one symptom of the "upper motor neuron syndrome," a condition caused by damage to portions of the brain or spinal cord controlling movement.

Spasticity does not necessarily interfere with the child's attempts at voluntary movement. It is essentially a property of passive movement. Therefore, spasticity is triggered by the interaction between the child and the environment. Impairment in voluntary movement is more often caused by symptoms associated with spasticity or the upper motor neuron syndrome (such as weakness, dystonia, or ataxia), rather than by the spasticity itself. In some cases, the increased tone due to spasticity is helpful to maintain the legs straight and thereby to support the child's weight against gravity. However, when spasticity is very severe, it may be present even when the child is not moving. This may lead to a rigidly fixed joint. The terms "spasticity" and "increased tone" may, in some cases, be used interchangeably.

Spasticity in children is most commonly due to cerebral palsy (CP), and there are sets of spasticity syndromes or patterns that are well recognized. These include...

Spastic diplegia (both legs involved greater than arms)
Hemiplegia (involves an arm and a leg on the same side of the body)
Double hemiplegia (both arms involved, more than legs)
Tetraplegia (all four limbs involved, usually severely)
Some clinicians distinguish between "plegia" (meaning complete paralysis) and "paresis" (meaning weakness)

Please see the following topics related to spasticity below, and available on the left side of this page.

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Section Author: Terence Sanger, MD PhD
Scientific Reviewers: Leon Dure, MD, Associate Professor of Pediatrics and Neurology, The University of Alabama at Birmingham; Marjorie A Garvey, MD, Pediatrics and Developmental Neuropsychiatry Branch, NIMH, Human Motor Control Section, NINDS; Jonathan W. Mink, MD PhD, Associate Professor of Neurology, Neurobiology & Anatomy, and Pediatrics Chief, Child Neurology, University of Rochester Medical Center, Rochester, New York
Editor: Joy B. Leffler, NASW, AMIA