spasticity and movement disorders Flashcards
what defines spasticity
(1) resistance to externally
imposed movement that increases with increasing speed
of stretch and varies with the direction of joint m ovement, and/
or (2) resistance to externally imposed movement that rises
rapidly above a threshold speed or joint angle. it is a isokinetic movement disorder because the amount of movement
is not increased or decreased
what causes spasticty from a physiology standpoint
There is probably reduced reciprocal inhibition
of antagonistic m otor pools by Ia a erents and decreased
nonreciprocal inhibition by Ib termina
what is a heredtary spastic parapalegia
(Strümpell-Lorrain disease), which is often misdiagnosed as
CP.17 Hereditary spastic paraparesis is characterized by no history
of perinatal asphyxia, normal intellect, slightly delayed
motor milestones, and slowly progressive spastic paraparesis
where is mechanism of action of baclofen
decrease release of inhbitory neurotransmittes in rexed laminae I and II
what are receptors for diazepam
GABA a and GABAb
site fo action of tizanidine
alpa 2 agonist
site of location of dantroline
sarcoplasmic reticulum, where it prevents the calcium influx
necessary for muscle contraction
what is length of time of botulimim effects
commences
within 1 to 3 days, is maximal at 21 days, and wanes—
perhaps because of the development of new neuromuscular
junctions—by 3 to 4 months afterward
timing of effects of IT baclofen use
diminish in 2 hours, is maximally reduced in 4 hours, and recurs
in 8 to 10 hours.
what is rate of baclofen clearance from CSF
same as CSF roughly 30ml/hr
what are symptoms of baclofen withdrawl
Withdrawal
symptoms of itching, agitation, and spasms are common; seizures
and fever may occur; and severe symptoms, such as hyperthermia,
psychosis, and multiple-organ failure, have been reported
how does withdrawl get treated
large doses of oral baclofen, evaluated
urgently, and have the malfunct ion repaired promptly
