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Spasticity and Spasms in Hemiplegia and Paraplegia *
Author(s) -
GLASER GILBERT H.
Publication year - 1961
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.1961.tb15334.x
Subject(s) - spasticity , paraplegia , medicine , spastic , lesion , proprioception , stretch reflex , spinal cord , physical medicine and rehabilitation , neuroscience , reticular formation , reflex , psychology , anatomy , electromyography , central nervous system , anesthesia , cerebral palsy , pathology
SUMMARY There are differences between the spasticities appearing in hemiplegia due to supraspinal lesions and in paraplegia due to spinal lesions, although the basic quality is progressive increased tension in muscles in response to stretch. Spasticity in hemiplegia is characterised by extensor predominance in the lower extremity and flexor predominance in the upper. In spinal paraplegia the spastic lower extremities are usually in flexion, although occasionally extension is present, more so with incomplete spinal lesions. Spasms, or rapid involuntary muscular contractions, have a similar distribution in the two states and may be spontaneous or induced by a variety of stimuli. The general physiological mechanisms involve exaggerated spinal stretch reflexes, due to release from and facilitation by supraspinal controls, especially reticular and cerebellar influences, increased susceptibility to proprioceptive stimuli, and possible overactivity in the gamma control system of the muscle spindles. Other special factors in spinal lesions include irritative phenomena at the site of the lesion and excessive activity at interneurones related to sprouting of boutons.