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Life Care Planning for Acquired Brain Injury
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
David L. Ripley, Roger O. Weed
Typical neurological problems include weakness, sensory deficits, and the previously mentioned cranial nerve problems. Individuals who have had a brain injury are at increased risk for developing seizures. The presence of a penetrating brain injury, skull fracture, or significant amounts of subarachnoid blood increases the risk for seizures. The upper motor neuron syndrome is possibly the most frequently seen neurological complication after all forms of brain injury, with its constellation of symptoms of weakness, spasticity, and increased reflexes. Spasticity is a velocity-dependent increase in motor tone that is seen frequently following injury to motor nerves in the central nervous system. This is such a profound problem after brain injury that it will be discussed in detail later in the chapter. Additionally, cognitive and behavioral problems are frequent neurological complications and will also be discussed in more detail later.
Hereditary Spastic Paraparesis and Other Hereditary Myelopathies
Published in Anand D. Pandyan, Hermie J. Hermens, Bernard A. Conway, Neurological Rehabilitation, 2018
Jon Marsden, Lisa Bunn, Amanda Denton, Krishnan Padmakumari Sivaraman Nair
An example of the clinical presentation and management from each clinical group of hereditary myelopathies will be described. The level of understanding of the underlying genetics can vary between the different hereditary myelopathies and this will be briefly described. Further, the hereditary myelopathies can have quite diverse additional symptoms and pharmacological and rehabilitation management. This will be described with particular emphasis placed on the management of spasticity and the upper motor neuron syndrome and its impact on functional ability.
Neuromuscular disorders
Published in Ashley W. Blom, David Warwick, Michael R. Whitehouse, Apley and Solomon’s System of Orthopaedics and Trauma, 2017
Most commonly the limbs will show the typical features of an upper motor neuron syndrome which include increased tone, brisk reflexes, a positive Babinski response and clonus, as well as important ‘negative’ signs such as weakness, poor coordination and poor selective muscle control. Spasticity gives the appearance of ‘strong’ muscles but actually muscle power is invariably relatively poor. It is associated with a loss of muscle excursion, reduced joint movement, secondary contractures, bony deformity, joint dislocations and pain.
Relationship between subarachnoid and central canal hemorrhage and spasticity: A first experimental study
Published in The Journal of Spinal Cord Medicine, 2021
Selim Kayaci, Mehmet Dumlu Aydin, Baris Ozoner, Tayfun Cakir, Orhan Bas, Sare Sipal
Spasticity is defined as muscle hypertonia that is characterized by muscle resistance, which increases in response to an externally applied movement that occurs when the muscle is tighter than its threshold level or rotation angle.1 Such condition is a characteristic of upper motor neuron syndrome.2 Clinically, this phenomenon refers to increased muscle tone, and widened reflex areas with increased deep tendon reflexes and clonus and is characterized by an increase in muscle resistance in response to passive muscle tension.3 It is an isokinetic movement disorder. Unlike that noted in hyperkinetic disorders (such as dystonia or chorea) the amount of movement does not increase.3 This condition is distinguished from rigidity based on the speed of muscle tension and its correlation to the existence of other positive upper motor neuron symptoms.4
Electroacupuncture with rehabilitation training for limb spasticity reduction in post-stroke patients: A systematic review and meta-analysis
Published in Topics in Stroke Rehabilitation, 2021
Jiyao Zhang, Luwen Zhu, Qiang Tang
After stroke, the patients may show several signs of upper motor neuron syndrome due to impaired sensory-motor networks and descending tracts,1 such as post-stroke spasticity, loss of selective motor control, and spastic co-contractions. Spasticity is often defined by dyskinesia characterized by increased velocity-dependent muscle tension due to increased excitability of stretch reflexes, which is accompanied by hyperreflexia.2 Post-stroke spasticity is manifested by increased muscle tension in the flexors of the upper limbs and the extensors of the lower limbs and by increased resistance during movement, which limits voluntary and coordinated movement, thereby significantly hindering the improvement of patients’ motor function and daily life ability. Moreover, after stroke, most patients experience some degree of spasticity3; data show that 6 months after stroke, the spasticity prevalence ranges from 25% to 43%.4
The level of evidence of medical marijuana use for treating disabilities: a scoping review
Published in Disability and Rehabilitation, 2020
Nichole Stetten, Jamie Pomeranz, Michael Moorhouse, Ali Yurasek, Amy V. Blue
The scoping review revealed six studies focusing on multiple sclerosis or other movement disorders. Three of the six studies focused on multiple sclerosis. One study focused on chronic upper motor neuron syndrome (UMNS), another study focused on dystonia, dyskinesia and tics and the final study focused on Parkinson’s disease. Two of the three studies on multiple sclerosis centered on the safety and efficacy of Savitex. The synthetic form of MJ, Savitex is a cannabis oromucosal spray, that is not approved for use in the USA but in European countries. Both studies were prospective safety studies that found that Sativex significantly improved spasticity [33,36]. The third study conducted a topical review on how cannabis effects cognition in patients with multiple sclerosis [32]. Although the topical review found that the use of CBs causes major cognitive deficits in individuals with multiple sclerosis, five out of the six studies reviewed were conducted by the same research team. Albeit being significant, these findings on cognitive deficits, need to be investigated further, to replicate the findings of the one research team dominating these findings. The scoping review points to significant potential in the use of Sativex to treat spasticity.