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Related Concept Videos

Spasmolytic Agents: Chemical Classification01:29

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Spasmolytic agents are drugs used to alleviate muscle spasms and spasticity. They can be categorized into different chemical groups based on their mechanisms of action. Centrally acting spasmolytics primarily affect the spinal cord, while others directly target skeletal muscle cells.
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Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
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Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Myasthenia gravis is a neuromuscular transmission disorder characterized by weakness and increased fatigability of skeletal muscles. It is an autoimmune disease affecting approximately one in 2000 people, where antibodies against the α1 subunit of nicotinic acetylcholine receptors are produced.
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Achieving balance in upper limb spasticity management.

Wee Lam1,2, Caroline Leclercq3, Shai Luria4

  • 1Hand and Reconstructive Microsurgery, Singapore General Hospital, KK Women's and Children's Hospital, Singapore.

The Journal of Hand Surgery, European Volume
|March 28, 2026
PubMed
Summary
This summary is machine-generated.

Managing upper limb spasticity requires individualized assessment and surgical strategies. Addressing challenges like tone, wrist function, and grasp recovery is crucial for restoring balance and improving patient outcomes.

Keywords:
arthrodesisbalancedystoniafunctionalgrasp and releasehyperselective neurectomynon-functionalspasticitytendon lengthening

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Area of Science:

  • Neurology
  • Orthopedic Surgery
  • Rehabilitation Medicine

Background:

  • Upper limb spasticity arises from central nervous system damage, disrupting spinal reflexes and causing muscle imbalance.
  • This imbalance leads to loss of coordinated motion across joints, significantly impacting function.
  • Current management requires detailed, individualized patient assessment within a multidisciplinary setting.

Purpose of the Study:

  • To examine challenging decision-making areas in surgical management of upper limb spasticity.
  • To discuss evidence-based treatments for tone management, wrist spasticity, grasp/release recovery, and dystonia.
  • To highlight unresolved issues and future research directions in spasticity management.

Main Methods:

  • Review of surgical options including bony, tendon, and nerve procedures.
  • Analysis of four challenging decision-making areas: tone management, wrist stability vs. mobility, grasp/release, and dystonia.
  • Discussion of evidence-based treatments and current literature.

Main Results:

  • Surgical interventions aim to reduce tone, release contractures, or reanimate muscles.
  • Key decisions involve choosing between lengthening procedures and hyperselective neurectomy for tone.
  • Optimizing wrist stability versus mobility and improving grasp/release function are critical considerations.

Conclusions:

  • Restoring balance in the spastic upper limb, particularly with lost voluntary control, is a complex surgical challenge.
  • A deep understanding of biomechanics and neurological pathways is essential for hand surgeons.
  • Multidisciplinary team collaboration and comprehensive assessment are vital for accurate diagnosis and individualized care.