Spaszticitás

Spaszticitás, in Hungarian medical usage, refers to spasticity, a motor disorder defined by velocity-dependent increases in tonic stretch reflexes, resulting in resistance to passive movement. It is a component of the upper motor neuron syndrome and is influenced by limb position and movement.

Causes of spaszticitás are diverse but share common CNS origins. It frequently follows stroke, spinal cord injury, multiple sclerosis, traumatic brain injury, or cerebral palsy. It may be unilateral or bilateral and can emerge in the acute phase or develop gradually as recovery progresses.

The pathophysiology involves impaired descending inhibitory control over alpha motor neurons due to corticospinal tract damage. This leads to hyperexcitability of the stretch reflex and changes in muscle properties, including connective tissue and passive resistance, contributing to the characteristic velocity-dependent tone increase.

Clinically, spaszticitás presents as increased muscle tone that worsens with faster movement, with possible clonus, exaggerated deep tendon reflexes, and a sudden “catch” during range of motion. It often coexists with pain, difficulty in gait or hand function, sleep disturbance, and can contribute to contractures if untreated.

Diagnosis relies on clinical examination, complemented by scales such as the Modified Ashworth Scale or the Tardieu scale to quantify tone. It is important to distinguish spaszticitás from dystonia, rigidity, or soft tissue limitations when planning treatment.

Management is multidisciplinary. Nonpharmacologic strategies include physical therapy, regular stretching, positioning, and use of orthotics to reduce contractures. Pharmacologic options include oral or intrathecal baclofen, tizanidine, and benzodiazepines; botulinum toxin injections for focal spasticity; phenol blocks and surgical interventions in selected cases. Ongoing assessment guides adjustments in therapy.