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Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy.
J Neurol 2018; 265(4):856-862JN

Abstract

Spasticity is a symptom occurring in many neurological conditions including stroke, multiple sclerosis, hypoxic brain damage, traumatic brain injury, tumours and heredodegenerative diseases. It affects large numbers of patients and may cause major disability. So far, spasticity has merely been described as part of the upper motor neurone syndrome or defined in a narrowed neurophysiological sense. This consensus organised by IAB-Interdisciplinary Working Group Movement Disorders wants to provide a brief and practical new definition of spasticity-for the first time-based on its various forms of muscle hyperactivity as described in the current movement disorders terminology. We propose the following new definition system: Spasticity describes involuntary muscle hyperactivity in the presence of central paresis. The involuntary muscle hyperactivity can consist of various forms of muscle hyperactivity: spasticity sensu strictu describes involuntary muscle hyperactivity triggered by rapid passive joint movements, rigidity involuntary muscle hyperactivity triggered by slow passive joint movements, dystonia spontaneous involuntary muscle hyperactivity and spasms complex involuntary movements usually triggered by sensory or acoustic stimuli. Spasticity can be described by a documentation system grouped along clinical picture (axis 1), aetiology (axis 2), localisation (axis 3) and additional central nervous system deficits (axis 4). Our new definition allows distinction of spasticity components accessible to BT therapy and those inaccessible. The documentation sheet presented provides essential information for planning of BT therapy.

Authors+Show Affiliations

Head of Movement Disorders Section, Department of Neurology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany. dressler.dirk@mh-hannover.de.Chulalongkorn Centre for Excellence on Parkinson's Disease and Related Disorders, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.Department of Neurology, King Faisal Specialist Hospital, Riyyad, Kingdom of Saudi Arabia.Department of Neurology, University of Santiago de Chile, Santiago de Chile, Chile.Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil.University of Sao Paulo, Sao Paulo, Brazil.Azienda Ospedaliera Santa Maria di Terni, Terni, Italy.Median-Klinik Bad Salzuflen, Bad Salzuflen, Germany.Gailtal-Klinik, Hermagor, Austria.Helios-Klinik Leezen, Leezen, Germany.Department of Neurology, University of Tokushima, Tokushima, Japan.Department of Neurology, Palacky University, Olomouc, Czech Republic.Centre de Rééducation et Medicine Physique, Hôpital du Jura, Porrentruy, Switzerland.Department of Neurology, Hospital de Clínicas José de San Martín, University of Buenos Aires, Buenos Aires, Argentina.Clinic 'Cecil Plus', Moscow, Russia.Department of Neurology, Rheinische Friedrich-Wilhelms-Universität, Bonn, Germany.Department of Neurology, Ljubljana University Medical Centre, Ljubljana, Slovenia.Department of Neurology, University of Zagreb, Zagreb, Croatia.Department of Neurology, University of Santo Tomas Hospital, Manila, Philippines.Department of Neurology, University of Monterrey, Monterrey, Nueva Leon, Mexico.Maternus-Klinik für Rehabilitation, Bad Oeynhausen, Germany.Movement Disorders Clinic, Department of Neurology, Rasoul-e Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.Federal State Hospital for Treatment and Rehabilitation of the Ministry of Health and Social Development of the Russian Federation, Moscow, Russia.Department of Neurology, Rostock University, Rostock, Germany.IAB-Interdisciplinary Working Group for Movement Disorders, Hamburg, Germany.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29423615

Citation

Dressler, Dirk, et al. "Defining Spasticity: a New Approach Considering Current Movement Disorders Terminology and Botulinum Toxin Therapy." Journal of Neurology, vol. 265, no. 4, 2018, pp. 856-862.
Dressler D, Bhidayasiri R, Bohlega S, et al. Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy. J Neurol. 2018;265(4):856-862.
Dressler, D., Bhidayasiri, R., Bohlega, S., Chana, P., Chien, H. F., Chung, T. M., ... Saberi, F. A. (2018). Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy. Journal of Neurology, 265(4), pp. 856-862. doi:10.1007/s00415-018-8759-1.
Dressler D, et al. Defining Spasticity: a New Approach Considering Current Movement Disorders Terminology and Botulinum Toxin Therapy. J Neurol. 2018;265(4):856-862. PubMed PMID: 29423615.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Defining spasticity: a new approach considering current movement disorders terminology and botulinum toxin therapy. AU - Dressler,Dirk, AU - Bhidayasiri,Roongroj, AU - Bohlega,Saeed, AU - Chana,Pedro, AU - Chien,Hsin Fen, AU - Chung,Tae Mo, AU - Colosimo,Carlo, AU - Ebke,Markus, AU - Fedoroff,Klemens, AU - Frank,Bernd, AU - Kaji,Ryuji, AU - Kanovsky,Petr, AU - Koçer,Serdar, AU - Micheli,Federico, AU - Orlova,Olga, AU - Paus,Sebastian, AU - Pirtosek,Zvezdan, AU - Relja,Maja, AU - Rosales,Raymond L, AU - Sagástegui-Rodríguez,José Alberto, AU - Schoenle,Paul W, AU - Shahidi,Gholam Ali, AU - Timerbaeva,Sofia, AU - Walter,Uwe, AU - Saberi,Fereshte Adib, Y1 - 2018/02/08/ PY - 2017/10/23/received PY - 2018/01/18/accepted PY - 2018/01/17/revised PY - 2018/2/10/pubmed PY - 2018/9/8/medline PY - 2018/2/10/entrez KW - Botulinum toxin therapy KW - Contractures KW - Dystonia KW - Rigidity KW - Spasms KW - Spasticity KW - Treatment SP - 856 EP - 862 JF - Journal of neurology JO - J. Neurol. VL - 265 IS - 4 N2 - Spasticity is a symptom occurring in many neurological conditions including stroke, multiple sclerosis, hypoxic brain damage, traumatic brain injury, tumours and heredodegenerative diseases. It affects large numbers of patients and may cause major disability. So far, spasticity has merely been described as part of the upper motor neurone syndrome or defined in a narrowed neurophysiological sense. This consensus organised by IAB-Interdisciplinary Working Group Movement Disorders wants to provide a brief and practical new definition of spasticity-for the first time-based on its various forms of muscle hyperactivity as described in the current movement disorders terminology. We propose the following new definition system: Spasticity describes involuntary muscle hyperactivity in the presence of central paresis. The involuntary muscle hyperactivity can consist of various forms of muscle hyperactivity: spasticity sensu strictu describes involuntary muscle hyperactivity triggered by rapid passive joint movements, rigidity involuntary muscle hyperactivity triggered by slow passive joint movements, dystonia spontaneous involuntary muscle hyperactivity and spasms complex involuntary movements usually triggered by sensory or acoustic stimuli. Spasticity can be described by a documentation system grouped along clinical picture (axis 1), aetiology (axis 2), localisation (axis 3) and additional central nervous system deficits (axis 4). Our new definition allows distinction of spasticity components accessible to BT therapy and those inaccessible. The documentation sheet presented provides essential information for planning of BT therapy. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/29423615/Defining_spasticity:_a_new_approach_considering_current_movement_disorders_terminology_and_botulinum_toxin_therapy_ L2 - https://dx.doi.org/10.1007/s00415-018-8759-1 DB - PRIME DP - Unbound Medicine ER -