Spasticity or reversible muscle hypertonia?

Area of Science:

• Neuroscience
• Clinical Neurology
• Rehabilitation Medicine

Background:

• The term 'muscle spasticity' is commonly used to describe increased resistance to passive stretch in paretic limbs after upper motor neurone lesions.
• This terminology is considered inaccurate as it does not fully encompass the complex pathogenesis or all contributing factors to altered muscle tone.

Purpose of the Study:

• To critically evaluate the current terminology used for increased muscle tone following upper motor neurone lesions.
• To propose an alternative and more accurate terminology that better reflects the underlying pathophysiology.
• To provide a rationale for the proposed terminology change.

Main Methods:

• Literature review and critical analysis of existing terminology.
• Pathophysiological review of upper motor neurone syndrome components.
• Conceptual framework development for alternative terminology.

Main Results:

• Current terminology ('spasticity') is insufficient to describe the multifaceted nature of altered muscle tone.
• Clinical observations of increased resistance to stretch involve various factors beyond simple hyperactive stretch reflexes.
• A proposed alternative terminology aims to provide a more comprehensive and accurate description.

Conclusions:

• The term 'spasticity' should be reconsidered due to its limitations in describing upper motor neurone-related muscle tone changes.
• Adopting a more precise terminology is crucial for accurate diagnosis, research, and clinical management.
• Further discussion and consensus are needed to implement revised terminology in clinical practice and scientific literature.