Clinical and electrophysiological investigation of spastic muscle overactivity in patients with disorders of consciousness following severe brain injury.
Clin Neurophysiol
; 130(2): 207-213, 2019 02.
Article
em En
| MEDLINE
| ID: mdl-30580243
ABSTRACT
OBJECTIVE:
The clinical and electrophysiological profile of spastic muscle overactivity (SMO) is poorly documented in patients with disorders of consciousness (DOC) following severe cortical and subcortical injury. We aim at investigating the link between the clinical observations of SMO and the electrophysiological spastic over-reactivity in patients with prolonged DOC.METHODS:
We prospectively enrolled adult patients with DOC at least 3â¯months post traumatic or non-traumatic brain injury. The spastic profile was investigated using the Modified Ashworth Scale and the Hmax/Mmax ratio. T1 MRI data and impact of medication were analyzed as well.RESULTS:
21 patients were included (mean age 41⯱â¯11â¯years; time since injury 4⯱â¯5â¯years; 9 women; 10 traumatic etiologies). Eighteen patients presented signs of SMO and 11 had an increased ratio. Eight patients presented signs of SMO but no increased ratio. We did not find any significant correlation between the ratio and the MAS score for each limb (all psâ¯>â¯0.05). The presence of medication was not significantly associated with a reduction in MAS scores or Hmax/Mmax ratios.CONCLUSIONS:
In this preliminary study, the Hmax/Mmax ratio does not seem to reflect the clinical MAS scores in patients with DOC. This supports the fact they do not only present spasticity but other forms of SMO and contracture.SIGNIFICANCE:
Patients with DOC are still in need of optimized tools to evaluate their spastic profile and therapeutic approaches should be adapted accordingly.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Transtornos da Consciência
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Lesões Encefálicas Traumáticas
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Espasticidade Muscular
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Adolescent
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Adult
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Female
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Clin Neurophysiol
Assunto da revista:
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article