Syndrome of muscular dystonia. The main symptoms of muscle hypertonicity and approaches to its therapy Types of hypertonicity

Muscle tone is the involuntary tension of our muscles. This process is permanent. Our consciousness and will do not control it.

Have you ever wondered how muscles tense up? What controls them? If the muscle tone is in a normal state, then we do not notice it. This is our usual state, which does not cause any discomfort. Despite the fact that we do not attach importance to this, the tone exists.

This is an important characteristic of our muscular system. It affects the state of all organs and systems. Without it, we will not be able to move normally, walk and even stand.

An important function of the skeletal muscles is to maintain their working condition. They must be in full readiness at any time, whether we are asleep or awake. And reflexively, the tone of the muscular system helps us maintain a certain position of our body.

What is the norm and what is the deviation

What is the difference between tonic muscle tension and normal? If the tension is arbitrary, then a number of muscle fibers are simultaneously activated.

Imagine that each fiber is a light bulb. During voluntary tension, the entire muscle will look like a bright fiery beam. But in the case of tonic tension, it will already resemble a sky strewn with stars. Notice the difference?

In the second case, the fibers will not all enter into work at once, but in turn: some tense up, while others rest. Thanks to this economy, the fibers can work for a very long time. In the distribution of tonic tension, the sensitivity of muscles and joints plays a decisive role.

Studies have shown that muscle tone can vary greatly from person to person. Even for one person at different points in his life, this indicator will change. For example, when we sleep, the tone is lowered. During mental or physical work, it will increase, and during rest and rest it will decrease again. With a reduced tone, efficiency is lost, but a high tone will interfere with productive work.

It is curious that muscle tone can affect the state of the human psyche. As it turned out, when the tone changes, our emotions also undergo changes. Reducing it can calm a person and even put him to sleep. But mentally controlling this indicator is quite difficult.

Hypertonicity - about causes and consequences

If the muscles are in a pathologically high tone, the following signs can signal this:

their density increased;
does not leave the feeling of tension;
you feel tight;
movements are constrained;
you feel muscle fatigue;
the rate of muscle growth slowed down;
often there are muscle spasms with acute pain.

There are two types of hypertension:

. On different groups muscle tone is disturbed in different ways.
Muscle rigidity. The tone is equally high in all muscle groups.

Why does hypertonicity appear

Most often, this pathology is associated with a violation of the nervous system. It is from her that signals come, after which the muscles relax or tighten. It is she who controls their tone. Increased muscle tone can appear for various reasons:

cardiovascular diseases (they damage the central nervous system);
neurological pathology congenital;
due to injury, the brain or spinal cord was damaged;
a person has demyelinating diseases.

And the tone may depend on psychological state. Our central nervous system often perceives all sorts of shocks and stresses as a potential threat, and sets in motion muscle tone. Slightly affect the tone and weather conditions. In warm weather, the muscles are relaxed, and the cold provokes their tension.

Types of muscle tone disorder

Violations muscle tone:

Muscle tone is observed in most newborns. At first, this is normal. It is due to the fact that the baby after the fetal position must get used to the new position of the body. Do not be afraid if your baby has been diagnosed with muscular dystonia.

Tone is an important characteristic of the state of the nervous system of the child and his general condition. Violations of it can be a symptom of serious pathologies of the central nervous system, spinal cord and brain. For example, dystonia always accompanies elevated intracranial pressure.

Violations of tone can provoke delays in physical and mental development. Such babies later begin to crawl, sit, walk.

Therefore, it is worth showing the baby to a neurologist. Babies born are considered a special risk group. ahead of time, "caesareans", children with low weight.

The consequences of violations of tone for children can be different:

posture, gait may deteriorate, sometimes clubfoot appears;
hypertonicity can later turn into hyperexcitability, the child will be inattentive, study poorly, and begin to show aggression;
hypotension leads to physical and psychological lethargy, apathy, hypodynamia, obesity, developmental delay.

It is important that parents monitor the condition of the child. For the first months, it is normal for the baby to stay in the fetal position. The newborn may experience increased muscle tension. For them, the physiological tone is normal. That is why even a newborn should not be left unattended on the changing table. He can actively move his legs, arms and even roll over.

Parents should be concerned if:

the hips of the newborn are divorced more than 90 degrees, this is a symptom;
spreading the hips of the child, you feel excessive resistance, this is a symptom of hypertonicity;
a symptom of a violation of tone is an unnatural posture of the child in the crib. In pathology, it can shrink into a ball or, conversely, spread out like a frog;
the child does not eat well, cries for no reason, throwing his head back;
convulsions and fever are observed;
the baby does not gurgle, does not smile.

You can not swaddle the baby tightly, even at night. With such swaddling, the child is in a very unnatural position. Doctors have noticed that babies who are not swaddled tightly are less likely to have impaired tone and neurological problems.

If, nevertheless, a correction of the tone is required, then therapeutic massage is most often prescribed. It is prescribed to babies after a month and a half age.

Medical therapy is rarely used. The specific treatment will depend on the underlying causes. Do not be afraid of massage.

The main thing is that it should be performed by an experienced and qualified children's masseur. A good professional massage normalizes muscle tone, improves blood circulation, and stabilizes the nervous system.

It is useful for a child to do simple exercises:

Stroke his back, the legs of the handle. At the same time, it is impossible to affect the lumbar region.
Massage your palms, heels, fingers on legs and arms. Movements should not be strong and abrupt.
After three months, the baby can already do more difficult exercises. They can be selected by a physiotherapy specialist.

To correct muscle tone, baths with herbs (soothing collection, motherwort, chamomile), sea salt will be useful.

Diagnostic tests

Special diagnostic tests will help determine the state of tone. The first examination of the baby is carried out in the hospital. Then, every six months, parents should show the baby to an orthopedist, a neurologist. Some manipulations for such a diagnosis can be performed by the parents themselves:

We part the hips. The baby lies on his back. You part his hips without any effort. The norm is moderate resistance. With a reduced tone, it is completely absent, and with an increased tone, it is too strong. A healthy baby should spread the legs 45 degrees on each side.
We sit the baby by the arms. The baby lies on its back. Pull the baby by the wrists as if you want to sit him down. The norm is a slight resistance to extension in the elbows of the hands. With a reduced tone, there will be no resistance, with an increased tone, it is excessive.
Step reflex and ground reflex. Holding under the armpits, place the baby on the changing table. To encourage you to take a step, lean forward slightly. Norma - the child stands and leans on the entire foot, his toes are straightened. While leaning forward, the baby should not cross the legs, imitates the process of walking. But after 1.5 months, this reflex fades. But with hypertonicity, it lasts longer. Symptoms of hypertonicity: pursed fingers, crossed legs. Symptoms of muscle hypotension in infants: steps on excessively bent legs (you must hold the baby under the armpits), squatting or refusing to walk.

Therapy Methods

As already mentioned, in case of violations of tone, professional therapeutic massage is often prescribed, less often - drug therapy. Most often, a neurologist prescribes a course of relaxing massage (10 professional sessions, which are repeated again after six months).

Also applies:

special medical gymnastics;
electrophoresis;
swimming;
relaxing baths with herbs (sage, valerian, motherwort, chamomile, soothing collection, needles) or sea salt;
in more complex cases, drugs are prescribed (vascular drugs, nootropics, diuretics).

Important: Recently, pediatricians have agreed that jumpers and walkers can harm muscular system child and the entire musculoskeletal system. In them, the force of gravity is unevenly distributed. It leads to excessive load on the spine and pelvis, muscle tension, the child gets used to not standing completely on the foot.

Remember that as you reach middle age, muscle tone may drop. It won't be too much to do therapeutic gymnastics or moderate loads gym. Remember that muscle tone directly depends general state your body, performance and emotional state!

I. Hypotension

II. Hypertension

Spasticity.
Extrapyramidal rigidity.
The phenomenon of opposition (gegenhalten).
catatonic rigidity.
Decortication and decerebration rigidity. Hormetonia.
Myotonia.
Muscle tension (Stiffness).
Reflex hypertension: muscular-tonic syndromes in diseases of the joints, muscles and spine; stiffness of the neck muscles with meningitis; increased muscle tone in peripheral injury.
Other types of muscle hypertension.
Psychogenic muscular hypertension.

I. Hypotension

Hypotension is manifested by a decrease in muscle tone below the normal physiological level and is most characteristic of damage at the spinal muscular level, but can also be observed in diseases of the cerebellum and some extrapyramidal disorders, especially chorea. The range of motion in the joints (their overextension) and the amplitude of passive excursions (especially in children) increase. With atony, the predetermined posture of the limb is not maintained.

Diseases that affect the segmental level of the nervous system include poliomyelitis, progressive spinal amyotrophy, syringomyelia, neuropathies and polyneuropathy, and other diseases that involve the anterior horns, posterior columns, roots, and peripheral nerves. In the acute phase of the transverse lesion spinal cord spinal shock develops, in which the activity of the cells of the anterior horns of the spinal cord and spinal reflexes is temporarily inhibited below the level of the lesion. The upper level of the spinal axis, the dysfunction of which can lead to atony, is the caudal parts of the brainstem, the involvement of which in deep coma is accompanied by complete atony and portends a poor outcome of the coma.

Muscle tone may be reduced in cerebellar lesions different type, chorea, akinetic epileptic seizures, deep sleep, during syncope, states of disturbed consciousness (fainting, metabolic coma) and immediately after death.

With cataplexy attacks, usually associated with narcolepsy, muscle atony develops in addition to weakness. Seizures are more often provoked by emotional stimuli and are usually accompanied by other manifestations of polysymptomatic narcolepsy. Rarely, cataplexy is a manifestation of a midbrain tumor. In the most acute (“shock”) phase of a stroke, a paralyzed limb sometimes reveals hypotension.

A separate problem is hypotension in infants(“flaccid child”), the causes of which are very diverse (stroke, Down syndrome, Prader-Willi syndrome, birth trauma, spinal muscular atrophy, congenital neuropathy with hypomyelination, congenital myasthenic syndromes, infant botulism, congenital myopathy, benign congenital hypotension).

Rarely, post-stroke hemiparesis (with an isolated lesion of the lentiform nucleus) is accompanied by a decrease in muscle tone.

II. Hypertension

Spasticity

Spasticity develops with any lesions of the cortical (upper) motor neuron and (mainly) the corticospinal (pyramidal) tract. In the genesis of spasticity, an imbalance of inhibitory and facilitating influences from the reticular formation of the midbrain and brain stem is important, followed by an imbalance of alpha and gamma motor neurons of the spinal cord. Often the phenomenon of "jackknife" is revealed. The degree of hypertonicity can vary from mild to extremely pronounced, when the doctor is unable to overcome spasticity. Spasticity is accompanied by tendon hyperreflexia and pathological reflexes, clonuses and, sometimes, protective reflexes and pathological synkinesis, as well as a decrease in superficial reflexes.

With hemiparesis or hemiplegia of cerebral origin, spasticity is most pronounced in the flexor muscles on the arms and extensor muscles on the legs. In bilateral cerebral (and some spinal) injuries, spasticity in the adductor muscles of the thigh leads to characteristic dysbasia. With relatively severe spinal injuries in the legs, flexor muscle spasm, reflexes of spinal automatism and flexor paraplegia are more often formed.

Extrapyramidal rigidity

Extrapyramidal rigidity is observed in diseases and injuries affecting the basal ganglia or their connections with the midbrain and the reticular formation of the brain stem. An increase in tone applies to both flexors and extensors (increased muscle tone according to the plastic type); resistance to passive movements is noted during movements of the limbs in all directions. The severity of rigidity may be different in the proximal and distal limbs, in the upper or lower body, as well as on the right or left half of it. At the same time, the phenomenon of "gear wheel" is often observed.

The main causes of extrapyramidal rigidity: rigidity of this type is most often observed in Parkinson's disease and other parkinsonian syndromes (vascular, toxic, hypoxic, postencephalitic, post-traumatic, and others). In this case, there is a tendency to gradually involve all muscles, but the muscles of the neck, trunk and flexors are affected more coarsely. Muscle rigidity is combined here with symptoms of hypokinesia and (or) low-frequency rest tremor (4-6 Hz). Postural disorders of varying severity are also characteristic. Rigidity on one side of the body increases with active movements of the contralateral limbs.

Less commonly, plastic hypertonicity is observed in tonic forms of dystonic syndromes (debut of generalized dystonia, tonic form of spastic torticollis, dystonia of the foot, etc.). This type of hypertonicity sometimes causes serious difficulties in making a syndromic differential diagnosis (parkinson's syndrome, dystonic syndrome, pyramidal syndrome). The most reliable way to recognize dystonia is to analyze its dynamics.

Dystonia (a term intended not to refer to muscle tone, but to a specific type of hyperkinesis) manifests itself muscle contractions, which lead to characteristic postural (dystonic) phenomena.

The phenomenon of opposition

The phenomenon of opposition or gegenhalten is manifested by increasing resistance to any passive movements in all directions. The doctor at the same time makes increasing efforts to overcome resistance.

Main reasons: the phenomenon is observed with damage to the corticospinal or mixed (corticospinal and extrapyramidal) pathways in the anterior (frontal) parts of the brain. The predominance of this symptom (as well as the grasping reflex) on one hand indicates a bilateral lesion of the frontal lobes with a predominance of damage in the contralateral hemisphere (metabolic, vascular, degenerative and other pathological processes).

Catatonic rigidity

There is no generally accepted definition of catatonia. This form of increased muscle tone is similar in many respects to extrapyramidal rigidity and probably has overlapping pathophysiological mechanisms with it. The phenomenon of "wax flexibility", given "freezing postures" (catalepsy), "strange motor skills" against the background of gross mental disorders in the picture of schizophrenia are characteristic. Catatonia is a syndrome that has not yet received a clear conceptual design. It is unusual in that it blurs the line between psychiatric and neurological disorders.

Main reasons: catatonia syndrome has been described in non-convulsive forms of status epilepticus, as well as in some gross organic brain lesions (brain tumor, diabetic ketoacidosis, hepatic encephalopathy), which, however, needs further clarification. Usually it is characteristic of schizophrenia. Within schizophrenia, catatonia presents with a complex of symptoms including mutism, psychosis, and unusual motor activity ranging from agitated outbursts to stupor. Concomitant manifestations: negativism, echolalia, echopraxia, stereotypes, mannerisms, automatic obedience.

Decortication and decerebration rigidity

Decerebrate rigidity is manifested by constant rigidity in all extensor muscles (anti-gravity muscles), which can sometimes increase (spontaneously or with painful stimulation in a patient in a coma), manifesting itself as forced extension of the arms and legs, their adduction, slight pronation and trismus. Decortication rigidity is manifested by flexion elbow joints and wrist with extension of the legs and feet. Decerebrate rigidity in patients in a coma ("extensor pathological postures", "extensor postural reactions") has a worse prognosis compared with decortication rigidity ("flexor pathological postures").

Similar generalized rigidity or spasticity with retraction (extension) of the neck and sometimes the trunk (opisthotonus) can be observed with meningitis or meningism, the tonic phase of an epileptic seizure, and with processes in the posterior cranial fossa that occur with intracranial hypertension.

A variant of extensor and flexor spasms in a patient in a coma is a rapidly changing muscle tone in the limbs (hormetonia) in patients in the acute phase of hemorrhagic stroke.

Myotonia

Congenital and acquired types of myotonia, myotonic dystrophy, paramyotonia and, sometimes, myxedema are manifested by increased muscle tone, which, as a rule, is detected not during passive movements, but after active voluntary contraction. With paramyotonia, a pronounced increase in muscle tone is provoked by cold. Myotonia is detected in the test of clenching the fingers into a fist, manifested by delayed relaxation of spasmodic muscles; repeated movements lead to the gradual restoration of normal movements. Electrical stimulation of the muscles causes increased contraction and delayed relaxation (the so-called myotonic response). Percussion (hit with a hammer) of the tongue or thenar reveals a characteristic myotonic phenomenon - a "dimple" at the site of impact and adduction thumb with delayed muscle relaxation. Muscles may be hypertrophied.

Muscle tension (stiffness)

Muscle tension is a special group of syndromes, associated by its pathogenesis mainly with spinal (interneurons) or peripheral damage (syndromes of "hyperactivity of motor units").

Isaacs syndrome (neuromyotonia, pseudomyotonia) is manifested by rigidity, which first appears in the distal extremities and gradually spreads to the proximal, axial and other muscles (face, bulbar muscles) with difficulty in movements, dysbasia and constant myokymia in the affected muscles.

Stiff-person syndrome, on the contrary, begins with rigidity of the axial and proximal muscles (mainly the muscles of the pelvic girdle and trunk) and is accompanied by characteristic spasms of great intensity in response to external stimuli of different modalities (enhanced startle response) .

Close to this group of muscular-tonic disorders are McArdle's disease, paroxysmal myoglobulinemia, tetanus (tetanus).

Tetanus is an infectious disease that manifests itself as generalized muscle rigidity, although the muscles of the face and mandible. Against this background, muscle spasms that occur spontaneously or in response to tactile, auditory, visual and other stimuli are characteristic. There is usually severe generalized rigidity between spasms.

"Reflex" rigidity

"Reflex" rigidity combines syndromes of muscle-tonic tension in response to pain irritation in diseases of the joints, spine and muscles (for example, protective muscle tension in appendicitis; myofascial syndromes; cervicogenic headaches; other vertebrogenic syndromes; increased muscle tone in peripheral injury).

Other types of muscle hypertension include muscle stiffness during an epileptic seizure, tetany, and some other conditions.

High muscle tone is observed during the tonic phase of generalized seizures. Sometimes there are purely tonic epileptic seizures without a clonic phase. The pathophysiology of this hypertonicity is not completely clear.

Tetany is manifested by a syndrome of increased neuromuscular excitability (symptoms of Khvostek, Trousseau, Erb, etc.), carpo-pedal spasms, paresthesias. More common variants of latent tetany against the background of hyperventilation and other psychovegetative disorders. A rarer cause is endocrinopathy (hypoparathyroidism).

Psychogenic hypertension

Psychogenic hypertension is most clearly manifested in the classic picture of a psychogenic (hysterical) seizure (pseudo-seizure) with the formation of a "hysterical arc", with a pseudodystonic variant of psychogenic hyperkinesis, and also (less often) in the picture of lower pseudoparaparesis with pseudohypertonia in the feet.

Normal muscle contractility ensures the harmonious physical and mental development of the child. Muscle tone in infants can be physiological and pathological. Physiological conditions include increased muscle tone in the first weeks after birth. Further, the tone should be normalized. If a child still has increased muscle tone two weeks after birth, this phenomenon is called hypertonicity and belongs to the category of pathological conditions.

Hypertonicity of the muscles of the newborn is an understandable phenomenon. Inside the womb, the child was in a shackled state. His limbs were tightly pressed to his body, there was no room for movement.

After birth, the baby's body gradually gets used to the new conditions. During the first two weeks, the muscles gradually relax, the limbs come to a new state. However, if the baby has CNS lesions of varying severity, the brain will not be able to fully control muscle activity. In this case, the state of the muscles will deviate from normal.

Preservation of hypertonicity during the first month of life should be the reason for the examination of the child by a neurologist.

Age norms

The following development of the situation is considered normal.

Pathology can be suspected from birth. Problems with the central nervous system are often expressed in the syndrome of muscle hypertonicity. In such children, all movements are constrained, the dilution of the lower extremities is no more than 45 o. The arms and legs are firmly pressed to the body, and the fingers cannot be unclenched.

What should alert

The syndrome of hypertonicity prevents the further development of the child, the formation of joints and ligaments is disrupted. Maintaining the state can lead to impaired motor skills, motor activity and formation of the spine, posture.

If after the first month of life, muscle hypertonicity in an infant persists, in the future it has the following symptoms.

The child is restless, sleeps poorly, wakes up in less than an hour, and cries frequently.
The baby burps profusely after every meal.
During sleep, the child arches its back and throws back its head. This is a characteristic feature of hypertonicity. At the same time, his arms and legs are bent and pressed to the body.
During a tantrum, the child is tense and bends. In a nervous state, trembling of the chin is noted.
The baby is able to keep his head in an upright position from birth.
When breeding the legs to the sides, a strong muscle tension is felt. When you try again, the tension intensifies. The child resists, protests with a cry.
In an upright position, the baby does not rest on the surface with the whole foot, it stands on its toes.

The existing signs of hypertonicity should encourage parents to seek advice from a neurologist.

On examination, the doctor reveals the presence or absence of certain reflexes in the child and their compliance with the age norm.

Walk reflex. In an upright position, the baby tends to take steps. Normally, this ability disappears after 2 months of age.
Symmetry of reflections. In the supine position, the child's chin is pressed against the chest. At the same time, the behavior of the limbs is observed - flexion of the arms and extension of the legs should occur. When the head is tilted to the right, there is straightening of the limbs on the right side and tension on the left. When you turn your head to the other side, everything happens exactly the opposite. This reflex should disappear after 3 months.
The ability to tone. In the prone position, the baby should tighten the limbs. In the supine position, the arms and legs are relaxed. After three months, the ability disappears.
When examining a newborn, the doctor places the child on his arm face down. In this position, the baby should experience contraction of the arms and relaxation of the legs. The head and back should normally be in a straight line.

Parents can detect symptoms on their own. If they suspect a violation, they should consult a doctor. A neurologist will be able to determine the presence or absence of a diagnosis and establish its type.

Nature of violations

Muscle tone can be either increased or decreased. Sometimes there is an imbalance - a combination of the first and second. In other words, increased tone of the muscles of the arms and reduced tone of the lower extremities may be present at the same time, or vice versa. This symptom is called dystonia.

With asymmetry, muscle hypertonicity occurs only on one side. This condition is also called torticollis. The child is placed in a prone position and viewed from the back. With asymmetry, the head is turned towards that half of the body where hypertonicity is manifested. On the same side, there is a bend in the back and tension in the arms.

Hypotension is also considered a violation. This phenomenon has symptoms inverse to hypertonicity, manifests itself in lethargy and impaired motor activity.

Muscular hypertonicity and hypotonicity may not appear systemically, but in separate parts of the body. In this case, there is a decrease or increase in muscle tone only of the arms, legs or back.

Violation of muscle tone is not an independent disease, but indicates other, more serious pathologies of the nervous system. That is why the symptoms of hypertension should not be ignored. When a child's syndrome is detected, it is necessary to comprehensively examine it. In this case, an ultrasound of the brain is done, and in rare cases, a tomogram.

Possible reasons

The causes of CNS damage can lie both in problems associated with pregnancy and in complications during childbirth.

Scroll possible causes lesions of the central nervous system in a child that caused a violation of muscle tone:

infectious diseases of the mother during pregnancy;
wrong lifestyle of a pregnant woman;
taking medications by the mother during pregnancy;
Rh-conflict of the future mother and fetus;
injuries received by the child during childbirth;
genetic incompatibility of parents;
unfavorable environmental situation.

The presence of these factors can only indirectly confirm the presence of a symptom of hypertonicity in a child.

Treatment should not only be aimed at correcting muscular dystonia, but also to identify and eliminate the main cause that caused the condition.

Methods of treatment

In the treatment of muscle tone disorders, non-drug methods are primarily used:

massage techniques;
water procedures (bathing in herbal infusions of valerian, motherwort, sage, excluding diving);
gymnastic exercises, with the exception of dynamic gymnastics;
physiotherapy;
osteopathic techniques.

When appointed medicines those that are able to improve cerebral circulation, establish metabolic processes and reduce muscle tension are selected.

Minor violations can hide serious causes. The harmonious development of the child should spread in all planes. Deviation in one area may lead to a violation in another area. Alarming symptoms of changes in muscle tone should not be ignored. On examination, the doctor will be able to determine in which direction to move on, what examination and treatment the child may need.

Content

Parents may sometimes notice that their children have physical development slightly behind the norm, there is a weak muscle tone. These symptoms cannot be ignored, because they indicate health problems that need to be treated in time. As a rule, with such manifestations, SMD is diagnosed - muscular dystonia.

What is muscular dystonia

The word "dystonia" is of Latin origin. It translates as "violation of tone." Doctors under the term "muscular dystonia" understand a disease that affects the muscles of the baby or an adult. Deviations can be observed not only in the direction of a decrease (hypotonicity), but also an increase (hypertonicity). Muscles can be affected on one side or symmetrically on both sides. Usually, lower limbs more prone to hypertonicity, and pens more often suffer from hypotonicity. The disease according to the ICD has the code G24.

Causes

Muscular dystonia syndrome is more common in infants, develops in most cases due to perinatal encephalopathy or standard brain damage during childbirth. Only in some cases does this occur even during fetal development. The baby can get such damage for the following reasons:

detachment of the placenta;
prolonged toxicosis of a pregnant woman;
polyhydramnios during pregnancy;
chronic fetal hypoxia;
the threat of miscarriage of any nature;
alcohol, nicotine intoxication during gestation;
long waterless period;
impact on future mother harmful factors;
too rapid / protracted childbirth;
caesarean section under general anesthesia;
profuse blood loss during childbirth;
entanglement of the umbilical cord inside the womb of the baby.

At the baby

In very young children, dystonic syndrome has pronounced symptoms from the very first days of life. Reduced muscle tone is easier for the baby and parents to tolerate: the child sleeps more, rarely cries. However, the baby noticeably later masters holding the head, turning over and other motor skills. The disease is accompanied by hypertonicity with the following symptoms:

trembling of the chin;
frequent crying;
sleep disturbance;
frequent regurgitation;
anxiety.

In children and adolescents

The presence of muscular dystonia syndrome in older children (over 2 years old) indicates disorders in the functioning of the nervous system. This reason becomes a provoking factor, affects the functioning, muscle tone. With the timely detection of the disease, the prescribed treatment will be more effective. Muscle dystonia must be diagnosed by a pediatrician and a neurologist.

In adults

A decrease in muscle tone in adults occurs due to a malfunction in the functioning of neural connections within the basal ganglia. They are located deep in the brain, are responsible for controlling any movement, maintaining correct posture. An acquired increase or decrease in muscle tone in an adult can manifest itself for the following reasons:

brain tumor;
stroke;
cerebral paralysis;
brain injury;
infection;
chorea of Huntington;
lead poisoning;
oxygen starvation;
Wilson-Konovalov disease;
drug treatment;
encephalitis.

Primary (idiopathic) dystonia in most cases is transmitted from parents. The manifestations of the disease can vary widely among members of the same family. The disorder can manifest itself when performing some specific tasks, for example, writing by hand. Deterioration of the condition can occur when taking medications from certain groups of drugs. Doctors say that this disease does not affect cognitive abilities (communication skills, memory).

Types of disease and their symptoms

As the main diagnosis, hypertension or hypotonia of the muscles can be made in infancy. In adults, it manifests itself more often at the age of 40-60 years. Adolescents are much less likely to experience such a disease. Doctors divide this disease into two types:

Primary - manifests itself against the background of a genetic predisposition. It is diagnosed when other diseases, neurological damage are not capable of causing this syndrome.
Secondary SMD - a disorder occurs against the background of the underlying condition. In most cases, it is caused by neurological injuries, genetic damage that affects the nervous system.

The syndrome can have different degrees of manifestation. Specialists, based on the severity of symptoms, distinguish several stages of the condition in dystonic syndrome:

The first stage - it is characterized by a slight tension in the muscles, but the tone relatively quickly returns to normal.
The second is that the signs are more noticeable during movement, after some time and during rest.
The third is clearly visible physical disorders that occur due to prolonged muscle spasms(the foot, spine, cerebral palsy, torticollis are bent).

Muscle hypertonicity

Increased tone in this syndrome is characterized by excessive tension of the extensor, flexor muscles. Signs can be mild or pronounced, for example, the child only resists a little while changing clothes or does not give the opportunity to control his body at all. The main manifestations of hypertension in a child include:

disturbing dream;
tightly pressed legs, arms to the body;
causeless crying;
the head is thrown back;
babies who have begun to walk move on their toes;
disturbing dream;
legs are strongly separated to the sides;
movement resistance;
attempts to roll over always only on one side;
frequent vomiting.

Doctors say that there is no reason to panic when diagnosing muscle hypertension in infants. By six months, the syndrome, as a rule, disappears without a trace, the development of the child continues in the usual direction. Nevertheless, if you suspect muscular dystonia, you should definitely conduct an examination and seek advice from your doctor. You may need to undergo treatment.

Muscle hypotension

The reverse state of the above syndrome is muscular hypotension. Instead of increased activity, the child has lethargy, weakness on the part of this system. Often parents are glad that their baby is very calm, but it should be remembered that this may be a sign of dystonia that has begun. The main symptoms include:

the baby does not hold his head well;
lack of desire to move;
sleeping too much;
little crying, almost always calm;
unable to hold anything in his hands.

How to treat impaired muscle tone

Treatment of SMD, as a rule, includes several directions at once and is complex. In infants, they first try to get by with only common therapeutic massage so as not to load a weak body with medicines. If the desired effect in eradicating the syndrome cannot be achieved, then the doctor's recommendations should not be abandoned. It is necessary to use all methods of treating this disease, which include:

gymnastics;
physiotherapy;
baths;
taking medications;
special massage.

This syndrome is not a sentence, it responds well to treatment, especially in the early stages. If the course is successful, it is necessary to continue to be observed by a specialist for a long time in order to respond in time with the development of a relapse, the possible negative consequences of the disease. The main task of parents is to carefully monitor the behavior and condition of their child and contact a specialist in time if they suspect the development of muscular dystonia.

Video

The most difficult thing to determine muscular dystonia in young children who are not yet able to say anything. An important factor in the successful treatment of this syndrome is timely access to a specialist, so it is important to understand how the disease manifests itself. The video below details the signs of SMD, methods of its treatment, gives the opinion of the famous pediatrician Komarovsky and an example of a simple massage for the disease.

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Muscle tone is essentially the degree of muscle elasticity and resistance that accompanies passive flexion or extension of the limbs. Muscle tone is due to various factors. First of all, it depends on the state of the muscles, peripheral nerve fibers and impulses. The ability of muscles to contract when overcoming a certain load is an important indicator of human health. It is absolutely normal that even in a relaxed state, the muscles are in some tension. As a result of diseases and damage to the nervous system, muscle tone can change. One or another type of violation leads to its decrease or increase. In accordance with this, hypo- and hypertonicity of the muscles are distinguished.

Increased muscle tone can be:

spastic;
rigid.

A distinctive feature of the spastic type is unevenness, selectivity. The cause of its occurrence are violations that affect the components of the pyramidal system. In this case, we are talking about a chain of neurons whose main task is to transmit motor commands addressed to skeletal muscles. Due to the fact that the central neuron in this system is damaged, spastic hypertonicity develops. Making movements of a passive nature occurs with difficulty, but this is characteristic of the very beginning of the action. In the future, these manipulations are performed quite easily. When making movements at a fast pace, such symptoms are more noticeable. Since there is damage in the motor center of the brain, the violation affects not one muscle, but their combination, for example, the flexor/extensor group of the feet. It is in this that the selective and uneven nature of this type of hypertonicity is manifested. Factors due to which it can occur are represented by strokes, brain injuries, various disorders of the nervous system, meningitis, sclerosis, hypoxia, phenylketonuria and other diseases.

Rigid increased muscle tone is also called plastic. It manifests itself if the extrapyramidal nervous system. This system includes brain structures and nerve pathways that are directly involved in both the regulation and control of motor manipulations. As a result of this, a motor reaction is organized when laughing or crying, a certain posture in space is maintained, and so on. Distinctive feature The rigid variety is that the difficulty in performing passive motor manipulations is permanent, resulting in spasm of all muscles. The limbs freeze in the positions they were given. In some cases, a damaged pyramidal and extrapyramidal system can lead to a mixed type of hypertonicity. As a rule, the cause of this pathology are brain tumors.

Causes of increased muscle tone

Muscle hypertonicity in adults is not in all cases associated with pathology, a characteristic feature of which is the persistence of its increase. Sometimes it is associated with physiological causes:

Tired, tense muscles. Performing work for a long time period, the muscles lose energy, which leads to fading muscle fiber in a reduced state.
The duration of being in an uncomfortable or monotonous position. Since in such a situation the entire load is associated with a certain type of muscle, spasm occurs, as with overstrain. Very often the appearance of such a spasm in neck muscles observed in people who sit at the computer for a long time. Hypertonicity of the back muscles in adults is often found in those who work in the garden for a long time.
Protective response to pain. In this case, we are talking about the occurrence of pain syndrome, spastic hypertonicity as a kind of reaction, for example, damage to the spine leads to spasm of the corresponding muscles.
Bruises, back pain. In the presence of pathologies of the spinal column, there is an increase in pain.

Muscle hypertonicity syndrome accompanies many different diseases. For example, it can be observed when:

acute circulatory disorders of the brain, which leads to ischemic and hemorrhagic stroke;
tumors of both the spinal cord and the brain;
craniocerebral injuries;
spastic form of torticollis;
bruxism;
dystonic syndrome;
hepatic encephalopathy;
infections of the central nervous system;
multiple sclerosis.

If such a condition for an adult is a deviation, then for a newborn it is within the normal range. It has to do with the position of the baby in the womb. Prolonged intrauterine stay in the fetal position is accompanied by close contact of the limbs, chin and torso, which leads to muscle tension in the fetus. clenched fists, bent legs, tilting the head - all these are signs of hypertonicity of a monthly baby.

Preservation of muscle tension at the age of six months is a serious reason for contacting a qualified specialist.

Symptoms and treatment

Like any disease, muscle hypertonicity has its own symptoms. Increased muscle tone in adults is characterized by:

tension, immobility;
discomfort during movement;
muscular stiffness;
spontaneous active movements;
increased tendon reflexes;
a slow process of relaxation of muscles that have undergone spasm.

In addition, hypertonicity of the calf muscles in adults is manifested by walking on "toes". This indicates the advanced nature of the disease with childhood. The occurrence of seizures is directly related to the tension of any muscle. With any mechanical impact, a person experiences severe pain. Hypertonicity of the muscles of the legs in adults as a result of prolonged stress leads to impaired blood circulation, the formation of painful seals.

Hypertonicity in newborns is characterized by:

restless, short sleep;
pretension of the upper and lower extremities;
tilted back position of the head;
resistance that accompanies attempts to breed the upper, lower limbs of the baby;
painful response to various stimuli, such as light;
frequent spitting up.

In the presence of the described signs of increased muscle tone, you should consult a doctor: a therapist or a neurologist. The rapid achievement of positive results of treatment is ensured by the timeliness of contacting a specialist. At the first stage of treatment, the underlying disease that provoked an increase in muscle tone is overcome. The second stage is corrective and aimed at facilitating therapy.

Muscle hypertonicity can be treated with:

relaxing massage;
physiotherapy exercises;
electrophoresis;
paraffin applications;
swimming;
medical treatment.

The main purpose of drug treatment is to minimize pain, normalize the functioning of the central nervous system. In each case, drug therapy may be associated with:

relief of symptoms;
reduction of spasmodic phenomena;
facilitation of movement.

Similar goals are achieved with the use of muscle relaxants, neuroleptics.

Timely diagnosis of muscle hypertonicity, compliance with the treatment prescribed by the doctor, regular physical exercise will allow to overcome the disease in a short time and reduce the risk of possible complications.