MULTIPLE SCLEROSIS AND SPASTICITY

MS is a disease of the nervous system affecting the brain, spinal cord and optic nerve.

It is an immune mediated process causing an abnormal response of the immune system attacking the myelin covering the nerve fibers.

Damaged areas of the myelin causes scar tissue (Sclerosis).

When the myelin covering or nerve fibers are damaged, impulses traveling to and from the brain and spinal cord are blocked and interrupted with resultant symptoms.

Symptoms

While symptoms of MS can be mild to severe, Spasticity is one of the most common. Spasticity causes involuntary muscle spasms in the form of sustained muscle contractions or sudden jerky movements. These will cause painful feelings of tightness and spasms most often in the legs.

One will have flexor spasticity, which affect the hamstring and the hip flexors causing the hips and knees to stay bent and are difficult to straighten causing a difficult gait.

One could also have extensor spasticity causing the quadriceps and adductors to be in spasms. This will cause the hips and knees to remain straight with the legs crossing each other.

These symptoms cause difficulties with ambulation, transfers, sitting and ADL and can be very painful and fatiguing.

 Management of spasticity

After comprehensive rehabilitation evaluation Physical therapy, Occupational therapy, exercises may improve the symptoms.

Antispastic medication will be prescribed orally first and if not effective, Botox injections can relieve spasticity in isolated muscles; however, Baclofen given intrathecally (Spinal) with an implanted pump is the most common and effective medication, since it is the only one that works by replacing GABA (a neurotransmitter) in the spinal fluid.

With neurologic diseases such as MS, spasticity is caused by the absence of GABA in the spinal fluid.