Spasticity or stiffness?

[Lavender Lady]

Just wondering exactly what these two things mean or are they they same? My hand that is mostly affected by weakness and atrophy and twitching in my pinky finger and ring finger i cannot lift and they want to curl under and now my other fingers are starting to feel like they are heading in that direction. Is that what spasticity or stiffness is?

Thanks, Rox

 

[johnnyliverpool]

roxy...al av a go at this..but i aint no expert and i will prob get shot down i flames...spasticity sure go hand in hand with contractures, thats the curling of your hands.......and stiffness too....muscles aint geting the signals....am useless at this......look type in upper motor neuron syndrome...you will get your answeres there..good luck....

 

[peter57]

Hi Rox.
There have been several recent threads and postings on just this topic. If you do a search for it or look at the bottom of this thread it might give you some answers.

If i temp to answer this you might get the wrong answer. Others are so much better in describing these sorts of things.


cheers
Peter

 

[Northern Dancer]

LAVENDER
When I was diagnosed with PLS in January I was completely unaware of the spasticity in my legs but I was aware of the extreme stiffness in my legs. I thought it was due to the problem of growing old. It seems my spasticity is constant ( came on steadily and gradually) so that I simply accepted it without defining it.

Lorna

 

[Lavender Lady]

Thanks for the input I will check the threads also.

Rox

 

[olly]

hi rox.
johnny is spot on and gets double brownie points.
stiffness comes with spasticity and in your hands it can curl up the fingers.
baclofen is used to help with these symptoms.

 

[johnnyliverpool]

whuaaay olly......praise indeed..your my teacher...al have to call you Miss..............to be fair i have picked up a lot of info on here..........and comformation from you makes my day........loves johnnymaidup

 

[Kohler]

In regard to the issue of stiffness, I have been confused by some of the information on here indicating that stiffness is not a symptom of MND/ALS. It seems to me that stiffness is inextricably linked with muscle weakness, and therefore is in fact a "de facto" symptom of possible ALS/MND (which this forum is for, just reminding...).

"Once a motor neuron degenerates completely, the muscle that it controls no longer receives impulses from the brain. Approximately 60% of ALS patients experience muscle weakness and stiffness as the initial symptom. Usually the first muscles affected are those in the arms and legs."

The site goes on to describe other symptoms, of course, but as stiffness was one of the things that my sister initially noticed in relation to her leg weakness, it seems to me that stiffness perhaps should be considered in terms of initial MND symptoms. I would be interested to hear from others who can relate their experiences with stiffness in relation to the progression of their symptoms/eventual diagnosis (or lack thereof).

 

[olly]

kohler.
the stiffness is caused by spasticity of the muscles which then weakens the muscles,this process is caused by umn involvment.
in pls the disease process tends to start in the legs and moves up the body over several years,umn symptoms are very prominant.
in als it may differ to the areas effected but some dont experience severe umn symptoms like those seen with pls.
really its all to do with the individuals disease process so you can not set someone as a prime example.

 

[Kohler]

Olly, in my sister's case, she is not experiencing spasticity (at least I don't think so, although I'm learning that some people, like ND above, are not aware of it at first). Since the stiffness doesn't seem to be a separate symptom, I'm assuming the stiffness can also be caused by the weakness...? In either, case, though, I would think stiffness would be considered as part of the symptoms for MND/ALS.

 

[joelc]

Stiffness is not an ALS symptom. Weakness is and to me there is a big difference.

 

[trfogey]

Olly, in my sister's case, she is not experiencing spasticity (at least I don't think so, although I'm learning that some people, like ND above, are not aware of it at first). Since the stiffness doesn't seem to be a separate symptom, I'm assuming the stiffness can also be caused by the weakness...? In either, case, though, I would think stiffness would be considered as part of the symptoms for MND/ALS.

Weakness caused by lower motor neuron death does not cause stiffness, at least in my experience. The muscles simply become flaccid and floppy. All the joints continue to flex and bend as long as no ligament or tendon contracture occurs, which is why passive range of motion exercises are so important.

kohler, you would be well-served to look up the difference between flaccid paralysis and spastic paralysis. There is a distinctive set of symptoms that go along with LMN problems and a different set of symptoms that go along with UMN problems. That's why the neuro's clinical exam is so important and why you should be careful about jumping to conclusions without considering the entire clinical picture.

 

[olly]

sorry tfogey and joel but i beg to differ.
there are those with als who do get some stiffness,as als is both umn and lmn thats not suprising.
those thought to have pls with umn symptoms can go onto develop significant lmn involvment to be classified as having als.
i have pls but have flaccid paralysis in my left lower leg,who knows why but i do not have als.
there are certain criteria,signs and symptoms but not everyone presents as a classic case.

 

[Kohler]

Olly, thanks, I have visited that forum but was not aware of that symptoms link.

 

[trfogey]

olly,

Far more people present as classic cases of these diseases than don't, especially in the early stages. That's why they are called "classic". Yes, people that have ALS will present with symptoms of both LMN and UMN problems -- that's a requirement for diagnosis. When that happens, it's usually fairly well along in the disease process and it takes experience and training to distinguish between them, which is why the neuro's clinical examination is so important.

kohler's sister is still early in the diagnostic process and has no diagnosis yet. kohler is trying to fit his/her research onto the known facts of his/her sister's condition. At this stage of the diagnostic process, it's not particularly useful, nor is it particularly kind, to send an honest researcher down the rabbit trails of atypical presentations and odd cases. Better that we should encourage people to look at the classic symptoms and classic presentations and leave the unusual stuff to the neurologist who has the case in front of him, don't you think?

That is, as I see it, the biggest disservice that this particular forum provides to the Internet as a whole -- providing a virtual sinkhole of odd and unverifiable cases that lead people to think that the "classic" symptoms of the various MNDs don't mean anything. Those same people continue to worry that they have an MND even though they do not have the classic presentation of symptoms because the odd and unverifiable cases are never definitively closed and well-meaning people keep telling folks around here that "each individual's case is different." And that is considered being "supportive" and "sympathetic"? Frankly, it strikes me as cruel and sadistic.

Far better to adopt the attitude of our friend Zaphoon -- it's not ALS until it can't be anything else.