#5 What are the different types of involuntary muscle contractions, & under what conditions do they occur? How do interventions such as botox, dorsal rhizotomy, & deep brain stimulation wk in treating abnormal muscle tone?

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Name the 5 different types of Involuntary Muscle contractions

muscle spasms, cramps, fasciculations, myoclonus and fibrillation

What are Muscle spasms

sudden, involuntary contractions of muscle

What are Cramps

particularly severe & painful muscle spasms

Cramps are common

following prolonged exercise, particularly if sweating has led to sodium depletion.

What are Fasciculations

quick twitches of muscle fibers of a single motor unit that R visible on the surface of the skin

Fasciculations are responsible for

eyelid twitches that sometimes accompany anxiety

What are Myoclonus

brief, involuntary contractions of a muscle or group of muscles

If you experience hiccups & muscle jerks that some people experience when falling asleep it is a result of

Myoclonus

What are Fibrillations

brief contractions of single muscle fibers NOT visible on surface of skin

Fibrillations abnormal movements are

ALWAYS pathologic

- Abnormal movements are generated by

dysfunctional basal ganglia

Pathologic myoclonus occurs which disorders

epilepsy, brain or SC injury, stroke, & chemical or drug poisoning.

What is the Surgical procedure used to reduce hyperreflexia/spasticity (decreasing stretch reflexes)

Dorsal rhizotomy

Dorsal rhizotomy Involves sectioning (cutting) of some of the sensory nerve fibers that come from the

muscles & enter the spinal cord.

During a Dorsal rhizotomy the

Abnormal rootlets are selectively cut, leaving the normal rootlets intact.

By cutting the abnormal rootlets Dorsal rhizotomy goal is to

reduces messages from the muscle, resulting in a better balance of activities of nerve cells in the SC, & reduces spasticity.

Botox is used to treat

abnormal muscle tone

Botox is Injected directly into the muscles that

produce excessive force.

Botox injections allows clinician to specifically

target particular muscles without interfering w/ the contraction of other muscles.

Botox injections Inhibits release of

Ach at the neuromuscular junction, preventing active muscular contraction.

Botox Injections into calf muscles produces

significant improvement in gait velocity, self-ratings of pain & gait function, manual muscle tests, & ankle clonus post stroke.

Deep brain stimulation (DBS) in treating abnormal muscle tone

Effective adjunct to drug therapy

Deep brain stimulation (DBS)

Requires surgical implantation of a stimulator & electrodes

Deep brain stimulation (DBS) Example to treat tremors in Parkinson's

electrodes R implanted into thalamus

Deep brain stimulation (DBS) with a Parkinson's Pt would promote

Continuous high-frequency electrical stimulation which would inhibits the firing of overactive thalamic neurons.

Bilateral subthalmic nucleas DBS

improves tremor, rigidity, & speed of movements

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