Results 1 to 8 of 8

Thread: spasms and tone

  1. #1
    Guest

    spasms and tone

    Hi all,

    First I want to give a couple of updates on Anthony. Two of Anthony's wounds are almost healed! There are two more to go one on the sacral and one on the buttock. And regarding his respiratory issues; his Dr. has heard and tried theophylline on other patients and started Anthony on it for his left diaphragm. He knew about the research. So we will see how it goes in about a month.

    I have questions regarding tone and spasms.

    When Anthony was admitted to Jackson Memorial his right arm was almost to contracture state and his left one was on its way. They did Botox injections in both biceps and the left one has responded excellent to it. They have been doing serial casting on the right arm and it is also now starting to respond good.

    Anthony has alot of tone almost all over except for his left side down to his stomach area. His left leg has very strong spasms as does his trunk sometimes. He has to wear leg braces at all times. Because of the tone they just bend up without them. He has been on Baclofen (80 mgs per day) now for about 3 mos; but it is not being effective. I stated to Anthony's Dr. maybe we could just live with the tone and spasms but he explained he would get contractures. His Dr. also mentioned the Baclofen pump but Anthony is not a good candidate for surgery. So he is going to try other medicines and hopefully we can find something that works.

    I am confused between spasms and tone are they two separate things? Do people without tone still have spasms? Do people that have spasms always have some tone?

    I am concerned about the medicines also and how they could effect muscles in the long-term. It was explained to me that Botox does not kill nerves/muscles BUT it does kill the receptors that lead to the muscles that is why they get relaxed BUT the receptors do grow back it is proved to not be permanent that is why these injections are given every 3 mos.

    As far as trying other drugs for spasms and/or tone are there any long-term permanent damage that they can cause that would prohibit ever using the muscles in the future; let's say when there is a cure? Thanks again.

    Cindy Waters
    mom
    Anthony C4 left side; C6 right side
    hospitalized at Jackson Memorial

  2. #2
    Senior Member dogger's Avatar
    Join Date
    Jun 2002
    Location
    Mitchell , Qld. Australia
    Posts
    2,239
    Cindy , ''spasms '' are the quick involuntary movements we get , ''tone [ or spasticity ] is when a muscle ''locks up '' . as for meds , i'll leave that to others , i take none , preferring to live with tone and spasms rather than the side effects i had , which was a weakening of functional muscles . i hope this helps .
    thank you ,
    dogger

    every day i wake up is a good one .

  3. #3
    Member
    Join Date
    Feb 2003
    Location
    Griffith, In
    Posts
    83
    Dogger, Does your tone get in the way of walking? Joe is starting to walk, but after a few steps, he can't overcome the tone in his left leg. His right leg has no tone or spams.
    He is taking baclofen, but it doesn't help the tone.

  4. #4
    Senior Member dogger's Avatar
    Join Date
    Jun 2002
    Location
    Mitchell , Qld. Australia
    Posts
    2,239
    Stacey , tone and spasms do affect my walking at times , but i just live with it and have found a few ways to try and limit them [not totally successfully ] , mainly stretching . i don't take any baclofen etc because i found it weakened me without being particularly beneficial [ i never got to high doses , as i observed this while ramping up ] . many others on baclofen have told me of this effect , so i chose strength with spasms/tone rather than reducing all three .
    thank you ,
    dogger

    every day i wake up is a good one .

  5. #5
    Stacey,
    I am a walking quad, and yes, my spasticity interferes with my walking, some days more than others. I never had any luck with baclofen, total of three trials, ramped up to 80 mg/day at one point, when side effects became a problem. I find zanaflex helpful, but too sedating to use during the day, so I only use it at bedtime. I take neurontin three times a day, and find it somewhat helpful. I don't see it used much by physiatrists for SCI's, but it is used sometimes by neuros for spasticity in MS patients, and it doesn't cause any side effects for me, and right now, a neuro is doing my med management. I also use valium as needed, end up using it almost daily, can use it up to three times a day, and I often find it quite helpful. There is another common medication used I haven't tried, I forget the name right now, my doctor told me he doesn't like to use it in women. So, his doctor could either try increasing the baclofen or try a different medication. For me, it took quite a while to figure out the right combination and dosages. In fact, my doctor finally gave me four different prescriptions and told me to go fill them all and play around with them until I figured out what worked best. (I had been an RN, so he trusted that I wouldn't do anything unsafe.)

    But about half of the time, nothing works medication wise for me. I don't know how long post injury Joe is, it sounds like he is pretty new, but I have found life management to be helpful as well. Long periods of immobility will lead to increased tone. Periods of stress and overactivity will also lead to increased tone, and there may be a delay factor. For example, if I walk too much on Tuesday, on Wednesday I will have increased spasticity. I need to keep my legs warm in cold weather, even though I will not feel cold, long underwear really helps. As Dogger said, stretching is important, and I find regular exercise and walking is also important. I need to be consistent, too much activity or too little activity both seem to be a problem for me. Joe may figure out his own strategies.

  6. #6
    I am confused between spasms and tone are they two separate things? Do people without tone still have spasms? Do people that have spasms always have some tone?
    Generally, spasticity and spasms go together. Spasticity is increased muscle reflexes and tone while spasms are spontaneous movements that often involve multiple joints and can be very strong. It is possible for a person who is on antispasticity medication that has reduced muscle tone and still get spasms. It is also possible for a person to have increased spasticity without spasms. The condition in which neither spasticity or spasms are present is called flaccidity.

    I am concerned about the medicines also and how they could effect muscles in the long-term. It was explained to me that Botox does not kill nerves/muscles BUT it does kill the receptors that lead to the muscles that is why they get relaxed BUT the receptors do grow back it is proved to not be permanent that is why these injections are given every 3 mos. As far as trying other drugs for spasms and/or tone are there any long-term permanent damage that they can cause that would prohibit ever using the muscles in the future; let's say when there is a cure? Thanks again.
    Botox or botulinum toxin is a neurotoxin and does have the potential to kill motoneurons. It causes denervation of the muscles. Whether the motoneurons die or not depend on the person, the dose, and the situation. The effects of botox on motoneurons tend to go away after several months. This may be because remaining motoneurons can sprout additional connections and compensate for lost receptors or lost motoneurons. Also, with repeated injections of botox, the body may develop antibodies against botox and its effect may decline.

    Wise.

    • Eleopra R, Tugnoli V, Quatrale R, Gastaldo E, Rossetto O, De Grandis D and Montecucco C (2002). Botulinum neurotoxin serotypes A and C do not affect motor units survival in humans: an electrophysiological study by motor units counting. Clin Neurophysiol 113:1258-64. Summary: OBJECTIVES: Botulinum neurotoxin serotype A (BoNT/A) is a valid therapy for dystonia but repeated BoNT/A injections may induce a clinical immuno-resistance that could be overcome by using other BoNT serotypes. In vitro experiments and our preliminary investigations in vivo, indicate that botulinum neurotoxin serotype C (BoNT/C) could be an effective alternative to BoNT/A. Moreover, in cultured neurons 'in vitro' BoNT/C has been reported to be more toxic than BoNT/A. METHODS: To verify this possibility, we compare the effect of BoNT/C and BoNT/A on the motor units count in humans by using the electrophysiological motor unit number estimation (MUNE) technique ('multiple point nerve stimulation'). Preliminarily, BoNT/C and BoNT/A dosage was calibrated in a mouse hemidiaphragm neuromuscular junction preparation. Subsequently, 8 volunteers were treated with 3IU of BoNT/C in the extensor digitorum brevis muscle of one foot and 3IU of BoNT/A in the contralateral one. Other 4 subjects were similarly injected at higher doses (10IU of BoNT/C or BoNT/A) to detect a possible dose-toxic effect. RESULTS: In both groups, no statistically significant variations in MUNE counting or single motor unit potential size were detected after 4 months from injections, when it was evident a recovery from the BoNTs blockade. CONCLUSIONS: We conclude that BoNT/C, similarly to BoNT/A, is safe and effective in humans and it could be proposed for a clinical use. Department of Clinical Neuroscience, Neurology Section, S.Anna University Hospital, corso Giovecca 203, Ferrara, Italy. releopra@global.it.


    • Aoki KR (2001). Pharmacology and immunology of botulinum toxin serotypes. J Neurol 248 Suppl 1:3-10. Summary: Botulinum toxin preparations can provide patients with a therapeutic modality that may improve both their medical condition and quality of life. The mechanism of action of the various botulinum toxin preparations and serotypes is similar: they all block neurotransmitter release. The majority of clinical conditions treated are based upon the targeted temporary chemodenervation of the selected organ. The antinociceptive effects of botulinum toxin type A (BTX-A), based on preclinical studies and clinical experiences in treating movement disorders and other painful conditions, will also be reviewed to illustrate how this compound may act as it alleviates the discomfort associated with various conditions. Chronic therapies with preparations with the lowest amount of neurotoxin protein provide the best chance for long-term therapy by minimizing the potential of the patient to form neutralizing antibodies. Differences in formulations or serotypes impart unique efficacy and safety profiles and thus does not support a simple dose ratio conversion between products. Allergan, Inc., Irvine, CA 92623, USA.


    • Pauri F, Boffa L, Cassetta E, Pasqualetti P and Rossini PM (2000). Botulinum toxin type-A treatment in spastic paraparesis: a neurophysiological study. J Neurol Sci 181:89-97. Summary: OBJECTIVE: The aim of this study was to verify the action of Botulinum toxin type-A (BoNT-A) by means of neurophysiological techniques, in patients presenting lower limb spasticity and requiring BoNT-A injections in the calf muscles, due to the poor response to medical antispastic treatment. SUBJECTS AND METHOD: Patients presenting paraparesis were enrolled. They underwent clinical evaluation for spasticity according to the Ashworth scale and neurophysiological recordings including: motor evoked potentials (MEPs) to transcranial magnetic stimulation (TMS) of the leg area; compound motor action potential (cMAP) to tibial nerve stimulation, F-wave, and H-reflex before the treatment and 24 h, 2 weeks and 1 month after the injection of BoNT-A. In all patients, gastrocnemius was treated and in some cases soleus or tibialis posterior muscles were also injected. RESULTS: In all patients, BoNT-A injections induced a clear clinical improvement as showed by the reduced spasticity values of the Ashworth scale. A significant increment of MEP latency and central conduction time (CCT) duration were observed 2 weeks after the treatment only in the injected muscles. CONCLUSIONS: Prolonged MEP latencies and CCT after BoNT-A injections is probably due to a central alteration in responsiveness of spinal motor neurons to descending impulses from the corticospinal tracts. Such changes represent objective parameters heralding clinical efficacy of treatment. AFaR-CRCCS Centro di Ricovero e Cura a Carattere Scientifico: Divisione di Neurologia, Ospedale Fatebenefratelli, Isola Tiberina 39, 00186, Roma, Italy.

  7. #7
    hey there, this is josh stevens, billies son that was in jackson memorial in september. how is anthony doing? take care. josh
    Originally posted by waters3:

    Hi all,

    First I want to give a couple of updates on Anthony. Two of Anthony's wounds are almost healed! There are two more to go one on the sacral and one on the buttock. And regarding his respiratory issues; his Dr. has heard and tried theophylline on other patients and started Anthony on it for his left diaphragm. He knew about the research. So we will see how it goes in about a month.

    I have questions regarding tone and spasms.

    When Anthony was admitted to Jackson Memorial his right arm was almost to contracture state and his left one was on its way. They did Botox injections in both biceps and the left one has responded excellent to it. They have been doing serial casting on the right arm and it is also now starting to respond good.

    Anthony has alot of tone almost all over except for his left side down to his stomach area. His left leg has very strong spasms as does his trunk sometimes. He has to wear leg braces at all times. Because of the tone they just bend up without them. He has been on Baclofen (80 mgs per day) now for about 3 mos; but it is not being effective. I stated to Anthony's Dr. maybe we could just live with the tone and spasms but he explained he would get contractures. His Dr. also mentioned the Baclofen pump but Anthony is not a good candidate for surgery. So he is going to try other medicines and hopefully we can find something that works.

    I am confused between spasms and tone are they two separate things? Do people without tone still have spasms? Do people that have spasms always have some tone?

    I am concerned about the medicines also and how they could effect muscles in the long-term. It was explained to me that Botox does not kill nerves/muscles BUT it does kill the receptors that lead to the muscles that is why they get relaxed BUT the receptors do grow back it is proved to not be permanent that is why these injections are given every 3 mos.

    As far as trying other drugs for spasms and/or tone are there any long-term permanent damage that they can cause that would prohibit ever using the muscles in the future; let's say when there is a cure? Thanks again.

    Cindy Waters
    mom
    Anthony C4 left side; C6 right side
    hospitalized at Jackson Memorial
    Josh Stevens

  8. #8
    Guest
    Dogger and Dunwawry, Thanks so much for your replies. Joe was injured thirteen months ago. We are already figuring some of these things out. If he has a tough workout one day, then the next his tone is so bad we can hardly get from the bedroom to the couch. It scares Joe because he looses what balance he has when the tone kicks in. When you're 6'4 it's a long way to the ground....
    Stacey

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •