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 play videoTime: 07:12 minutes |
Participants
, Jean-Micha Gracies MD, Mabel Jong , David Simpson MD
Summary
In the aftermath of a stroke, many people experience an uncontrollable tightness in the arms or legs that can cause pain and restrict movement. These symptoms are often accepted by patients as a new fact of life, but in truth they are part of a treatable condition called "spasticity".
Webcast Transcript
MABEL JONG: Hello and welcome to our webcast. I'm Mabel Jong. In the aftermath of a stroke, many people experience and uncontrollable tightness in the arms or legs that can cause pain and restrict movement. These symptoms are often accepted by patients as a new fact of life. But in truth they are part of a treatable condition called spasticity. Here today to talk about spasticity and how best to treat it are neurologist Dr. David Simpson of Mt. Sinai Hospital in New York and Dr. Jean-Michel Gracies, also at Mt. Sinai. Gentlemen, thanks for being with us today.
Well, first, let's start with you, Dr. Simpson. Please define for us spasticity and why it's so significant for stroke patients.
DAVID SIMPSON, MD: Well, spasticity refers as much to a symptom as to a disease. And it can occur after virtually any type of damage to the central nervous system, including the brain, the spinal cord and those nerve pathways. And what most people tend to associate with those types of brain and spinal cord injuries is weakness and loss of ability to move and to function. But what perhaps is as not well recognized is this phenomenon of muscle tightness. What that results in is excess muscle activity, tightness of muscles and often disfiguring muscle contractions which then results in a number of very bothersome symptoms. They're grouped under the phenomenon of spasticity.
MABEL JONG: Can you provide some examples of what you've seen in patients?
DAVID SIMPSON, MD: Well, most people are familiar with the type of patient, for instance, who's had a stroke who might be walking down the street with a very abnormal posture in which the arm is very tight and often crunched up against the chest or the leg is very stiff and swings out sideways when the patient is trying to walk. They may not even be able to put their foot flat on the ground.
The symptoms we also see in patients with spasticity is spasm of muscle, pain that results from this spasm and one of the most challenging group of symptoms is the inability to coordinate the limb. So an individual may not be able to pick up an object. They may not be able to write or even eat with their own hands because of this tightness of the muscles.
MABEL JONG: And what impact might be these symptoms have on the quality of life.
JEAN-MICHEL GRACIES, MD: We believe and we're here to try and treat the symptoms because we believe that the impact is potentially enormous. I remember a patient whose finger flexes, the muscles that curl the fingers and close the hands are called the finger flexes. And those muscles were so much active that this patient just wanted to be able to when sitting as a passenger in a car to be able to touch the window with the pulp of the finger because it's a kind of pleasant sensation. And just that was impossible because of that curling, the permanent hand closing activity.
The day we could release that overactivity in those muscles and the day the patient could just touch the window, there was a sense of satisfaction, elation. It was one very, very small example of how we can get unexpected benefits by releasing that excessive tension in muscles.
MABEL JONG: Let's start talking about some treatments. Is this condition treatable, Dr. Simpson?
DAVID SIMPSON, MD: It is treatable. There are many, many people with chronic spasticity who essentially have been given up upon. People assume that this is a condition that is going to remain with them for the rest of their lives and that there is no effective treatment available. And there have been some breakthroughs in treatment over the last decade or two that unfortunately is not being accessed as much as it might.
MABEL JONG: Dr.
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