Is there a good definition of spasm versus cramp?

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ktmj

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Sometimes my leg will begin to twitch all over, and eventually the foot and lower leg will extend straight, with toes pointing down. The funny thing is I can voluntarily stop it and it will be still for a while (this does not happen at night - only during day). My arm can do the same thing but usually the bicep starts twitching and contracting pulling the arm up slightly - can voluntarily stop that too. Is that a spasm or cramp - I would call it a cramp?

So what is spasticity? The muscle contracts and won't release voluntarily or involuntarily without stretching? Maybe a mute point, but trying to distinguish an UMN sign from LMN sign, or some totally different mechanism.

BTW, shoulders and chest muscles can do this too with me.:shock:
 

BethU

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Hi, Ktmi ... I'm replying just so you won't think nobody's read your message, but I'm afraid I don't have an answer to your question. Actually, I'm not sure I understand what you're asking.

When you say you can stop these spasms/cramps "voluntarily," do you mean you mentally tell the muscles to stop and they stop? Or do you do something specifically to make them stop? And I'm not sure what your shoulders and chest muscles are doing ... cramping, and then you make them stop?

Is your question simply, "what should these be called?" You can probably find definitions of cramps and spasms at Wikipedia.
 

ktmj

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Thanks Beth, let me be a little more specific - sorry for the confusion - this stuff going on is a little hard to describe in words.

The chest, shoulders, and to some extent my back and abdomen, will more twitch and cramp. It is not a hard cramp with pain, most of the time - occasionally it will be a little painful.

The twitching/cramping? I can stop voluntarily are the ones in my arms and legs. The bicep will start twitching and contracting, or my calf and foot will start tightening and drawing, and when I have had enough I can just conscieously make it stop usually with a little movement in the opposite direction, and it will stop completely for a few minutes or a few seconds. Weird I know.

I've read all the definitions - I was thinking spasticity was when a muscle contracted and held its position and there was really nothing you could do on your own other than range of motion or stretching to release it?

Hope that helps some...
 

BethU

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Hi, again ... I'm not sure what you should call these things either, other than "not-ALS." :)

This doesn't sound anything like ALS, and I've never heard of anybody being able to consciously stop muscles from twitching like that. I've had a few cramps over my lifetime that I could stop by pressing on a trigger point, or adjusting position. Those were usually connected to exercising.

I'd suggest you check out information on "Benign Fasciculation Syndrome." I don't think you'll get much information from people with ALS ...

Good luck.
 

susan morgan

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Leg shake when rising

My mother in law is 82 and was diagnosed with the bulbar form in May this year. She has rapidly deteriorated and now has no speech, she has difficulty swallowing and can only eat mush, drools constantly, her neck muscles have gone so her chin is permanently on her chest and walks with a frame. She has also lost a considerable amount of weight. Now down to 91 pounds. When she rises from her chair, (with great difficulty) one of her legs goes into spasm and shakes for a time. Is this a sign that the muscles are about to give up, as with her neck, and she will no longer be able to walk?
 

BethU

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Hi, Susan ... I'm so sorry about your mother-in-law. It sounds like it is very rapid progress indeed.

I don't know if the shaking of her leg is a "sign" or not, but it sounds as if her leg is affected, and I would expect the progression to continue.

Has her doctor suggested a neck brace for her, or a feeding tube? I hope the doctors can make her as comfortable as possible, and keep her nutrition up. There are medications that can help with the excess saliva and the drooling, too.
 

CindyM

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Hi Susan- sorry to hear about your MIL. This is a tough disease, for sure. I suspect you might be right that this is a sign she is progressing, unfortunately. But each PAL (People living with ALS) is different so there is still hope for many happy years to come.

I am glad you decided to join us. When you get some time, try poking around the site to learn all you can about ALS. Most folks say the search feature is helpful, and folks around here are caring and knowledgeable. Again, welcome! Cindy
 

ktmj

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Beth, thank you.

I have been trying to not diagnose myself on the internet, but call me guilty. I have an appointment at one of the best neuromuscular hospitals (and doc) tomorrow, so maybe I should just let him earn his money and take mine.:)
 

susan morgan

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Txs for the reply. She does have a neck brace but is unable to put it on or take it off herself. She also cannot open her mouth wwhen she is wearing it nor eat. She is on amilotryptiline for the drooling and whilst it worked initially it has returned with a vengeance.
 

Zaphoon

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Susan,

I have this picture in my head of this poor woman with her chin continually on her chest. Have you thought about a head strap? If she has a head rest on her chair, her head could be strapped to the head rest and be maintained in a more upright fashion.

Zaphoon
 

lydia

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ktmj

ktmj,
how was your appointment today? I am curious if your doctor labeled your muscle experiences (cramps? spasms?). I think you might be experiencing cramps...cramps can usually be stopped by shifting position of the affected limb. So if a cramp ends up pointing your toes down then deliberately pointing them up may cause the cramp to stop. I have cramps that distort my hands and feet, but never in my biceps...I was trying to picture what you described...

I saw that you describe twitching and then this experience that I think is cramps. I have lots of twitching and have noticed when the twitching seems overly excessive I also seem to experience more cramping; two distinctly different muscle events occurring at the same time (even though I experience them alone as well). I wonder if that is what you meant; if that is what you are experiencing.

With respect to differentiating between UMN and LMN signs, I am also trying to make sense of what spasticity is and have corresponded with several members trying to get at what it is exactly. But I still don't get it! I am also exploring the meaning of "rigidity". The definitions on the web are hard to translate into "lived experience". I will be seeing a movement disorder specialist soon; spasticity is something they treat, and I am hoping that what I am experiencing will fall under that classification so that I can then get some symptom relief.

Lydia
 

ktmj

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Hi lydia, thanks for asking.

He said what I was experiencing was cramps. After a full physical exam, he assured me I do not have ALS (and this guy is an ALS specialist and head of a major university neurology department).

He did tell me he thought my fear and some of my symptoms was related to anxiety. I'll also say he was very compassionate and unhurried in his approach. I did not feel like a number passing through.

He also said my first reaction today would be that he is crazy and start doubting him (I must admit it ran through my mind a few times).

I asked him about a needle and shock test :-D. He said he would be glad to take my money, but that he did not see a need to do another since I had one locally 10/1 and my clinical exam was clean.

So right now I am taking the approach that I do not have ALS and will not get it, will get some professional help to deal with it, and enjoy every day. It's a hard funk to dig out of I know, but I am going to give it my best effort.

My cheers go out to the brave men and women here that definitely have a neuromuscular diagnosis. Ya'll are some incredibly brave, compassionate, and loving people.

God bless you all, ktmj
 

lydia

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Well that is good news, try and believe it.:-D I hope your cramps subside!

Lydia
 

olly

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hello everyone

i have explained spasms and spasticity so many times,after 9yrs of these i am a pro lol.
a spasm is a brief muscular contraction,spasticity is sustained contraction(sustained as in it does not let up like a cramp).
spasticity as in umn involvement causes pain,stiffness,rigidity of joints(contractures) and weakness.
stretching the limb can help briefly but only meds like baclofen can control it,spasticity in umn involvement does not go away.
my example is a coil as the limb,the coil /limb is squeezed tight during muscle contraction causing shortening of the tendons and resulting in the symptoms you get.
this eventually over time sprains the coil/resulting in muscle weakness.

as for shaking limbs,this is caused by weakness.
i can sometimes have like a shaking tremor in my arms,legs and torso which my pt says is weakness.
ambulation(technical term for movement) causes muscle tremors
even with my legs at rest and feet firmly on the floor my muscles in the calf/thigh will quiver/shake.

hope this helps a little more:)
 

ktmj

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olly,

Good to hear your definition of spasticity. That's what I was thinking it was but that is a great explanation from the real world. Thank you!8)
 
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