Spasticity

Spasticity is commonly defined as a velocity-dependent increase in muscle tone with exaggerated tendon jerks resulting from hyperexcitability of the stretch reflex. Spasticity is one component of the upper motor neuron syndrome, which also includes hyperreflexia, clonus, muscle cocontraction, fatigability, and muscle weakness. Spasticity is not always a hindrance and each patient’s clinical situation should be carefully evaluated to look at the way spasticity is impeding his or her function, pain, physical condition, or caregiving. Furthermore, worsening of baseline spasticity should warrant a workup for noxious stimuli or infection as a cause. Options for treatment include oral medications such as baclofen and tizanidine as well as other interventional approaches such as chemodenervation coupled with rehabilitation, intrathecal baclofen, and/or surgical approaches.