Pediatric Movement Disorders - Spasticity

Workup

Spasticity usually becomes worse over the first several months following an injury; however, it typically remains stable after that time. This is also true in newborns, in which spasticity may not become evident until the age of 6 months or more. If there is worsening spasticity beyond this point, the suspicion for...

• Degenerative disease may prompt a metabolic workup
• A tethered cord or syringomyelia may prompt MRI imaging of the spinal cord
• A tumor may prompt MRI imaging of the brain

When spasticity is stable, it usually represents a fixed old injury to the brain or spinal cord. Further workup and evaluation are often unnecessary. The location of the injury may usually be determined from the neurological examination. If a diagnosis is needed, then a brain or spinal MRI often reveals the cause. If multiple sclerosis is suspected, then a MRI of the brain needs to be performed, including the injection of contrast dye to determine which, if any, lesions are currently active and which are likely to be old lesions.