• DOI:10.2340/16501977-0613
• Corpus ID: 8827778

How to clinically assess and treat muscle overactivity in spastic paresis.

@article{Yelnik2010HowTC,
  title={How to clinically assess and treat muscle overactivity in spastic paresis.},
  author={Alain P. Yelnik and Olivier Simon and Bernard M. Parratte and Jean-Michel Gracies},
  journal={Journal of rehabilitation medicine},
  year={2010},
  volume={42 9},
  pages={
          801-7
        }
}

• A. Yelnik, O. Simon, +1 author J. Gracies
• Published 1 October 2010
• Medicine, Psychology
• Journal of rehabilitation medicine

OBJECTIVE
This educational paper aims to describe, in adult patients, the different aspects of muscle overactivity after a central nervous system lesion, including spasticity, spastic dystonia and spastic co-contraction, the assessment of their symptoms and consequences, and therapeutic options.

DISCUSSION AND CONCLUSION
Clinical evaluation involves the assessment of passive range of motion, angle of catch or clonus, active range of motion, rapid alternating movements and functional consequences. A number of scales have been developed to assess patients with spastic paresis, involving both patient and caregivers. Not all persons with spasticity require treatment, which is considered only when muscle overactivity is disabling or problematic. A list of personal objectives may be proposed for each patient, which will drive assessment and treatment. Prior to treatment the patient must be informed of the intended benefits and possible adverse events. Clinical evaluation may be supported by the use of transient neuromuscular blocks and/or instrumental analysis. Physical therapies usually represent the mainstay of treatment. Self-rehabilitation with stretching and active exercises, intramuscular injections of botulinum toxin, alcohol or phenol injections, oral or intrathecal drugs, and surgery comprise the treatment options available to the clinician. Follow-up must be scheduled in order to assess the benefits of treatment and possible adverse events.