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Encyclopedia > Spastic Diplegia
Spastic diplegia
Classification & external resources
ICD-10 G80.1
MeSH D002547
"Little's disease" redirects here.

Spastic diplegia is a neuromuscular type of cerebral palsy involving hypertonia and spasticity in the muscles of the lower extremities, usually those of the legs, hips and pelvis. Doctor William John Little's first recorded encounter with cerebral palsy is reported to have been among pediatric patients who displayed signs of spastic diplegia; for this reason, spastic diplegia was widely known as Little's Disease for many years, and some clinicians continue to use this term.[citation needed] The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The following codes are used with International Statistical Classification of Diseases and Related Health Problems. ... // G00-G99 - Diseases of the nervous system (G00-G09) Inflammatory diseases of the central nervous system (G00) Bacterial meningitis, not elsewhere classified (G01) Meningitis in bacterial diseases classified elsewhere (G02) Meningitis in other infectious and parasitic diseases classified elsewhere (G03) Meningitis due to other and unspecified causes (G04) Encephalitis, myelitis... Medical Subject Headings (MeSH) is a huge controlled vocabulary (or metadata system) for the purpose of indexing journal articles and books in the life sciences. ... Main Entry: neu·ro·mus·cu·lar Pronunciation: nur-O-m&s-ky&-l&r, nyur- of or relating to nerves and muscles; especially : jointly involving nervous and muscular elements <a neuromuscular junction> ... This article or section is in need of attention from an expert on the subject. ... An increase in stiffness, tension, and spasticity of a muscle. ... Spasticity is a disorder of the bodys motor system in which certain muscles are continuously contracted. ... Extremities is a play by William Mastrosimone that was first performed on Broadway in 1982. ... In an extended sense, a leg is any part of an object that supports it off the ground. ... In anatomy, the hip is the bony projection of the femur which is known as the greater trochanter, and the overlying muscle and fat. ... The pelvis (pl. ... William John Little was an English surgeon who, in the 1860s, identified spastic diplegia in children. ...


This condition is by far the most common type of CP, occurring in almost 70% of all cases.

Contents

Causes

Brain damage at birth prevents proper development of the pyramidal tract, motor cortex or corticospinal tract, meaning that certain nerve receptors in the spine are in turn unable to properly absorb the gamma amino butyric acid (GABA) which would otherwise properly regulate tone in the affected areas. Without GABA, affected nerves perpetually fire the message for their corresponding muscles to contract and tighten up, resulting in tightness and stiffness in movement for the person. Almost universally, damage is sustained before, during, or shortly after birth from neonatal asphyxia, hypoxia of the brain, premature birth, birth trauma, hematoma in the brain, or the presence of certain maternal infections during pregnancy. Known post-birth causes of spastic diplegia, meanwhile, may include exposure to toxins, traumatic brain injury, encephalitis, meningitis or other brain infections, and drowning or suffocation, though these post-birth causes are comparatively rare. Brain damage or brain injury is the destruction or degeneration of brain cells. ... The corticospinal or pyramidal tract is a massive collection of axons that travel between the cerebral cortex of the brain, and the spinal cord. ... To meet Wikipedias quality standards, this article or section may require cleanup. ... The corticospinal or pyramidal tract is a massive collection of axons that travel between the cerebral cortex of the brain and the spinal cord. ... The Spinal cord nested in the vertebral column. ... Gamma-aminobutyric acid (usually abbreviated to GABA) is an inhibitory neurotransmitter found in the nervous systems of widely divergent species. ... Suffocation redirects here, for the band, see Suffocation (band). ... Hypoxia may refer to: Hypoxia (medical), the lack of oxygen in tissues Hypoxia or Oxygen depletion, a reduced concentration of dissolved oxygen in a water body leading to stress or even death in aquatic organisms This is a disambiguation page: a list of articles associated with the same title. ... // Premature birth (also known as preterm birth) is defined medically as childbirth occurring earlier than 37 completed weeks of gestation. ... Pre- and perinatal psychology is the study of the psychological implications of the earliest experiences of the individual, before (prenatal) and during (perinatal) childbirth. ... Hematoma on an elbow, nine days after a blood sample was taken Hematoma on a forearm, one day after repeated shocks A hematoma, or haematoma, is a collection of blood, generally the result of hemorrhage, or, more specifically, internal bleeding. ... For a list of biologically injurious substances, including toxins and other materials, as well as their effects, see poison. ... Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. ... Encephalitis is an acute inflammation of the brain, commonly caused by a viral infection. ... Meningitis is the inflammation of the protective membranes covering the central nervous system, known collectively as the meninges. ...


Presentation

The degree of spasticity in spastic diplegia, and, for that matter, other types of spastic CP, can and almost always does vary very widely from person to person. No two people with spastic diplegia are exactly alike. The condition is congenital (occurring at birth), but is not transmittable, since despite the nickname "Little's Disease," spastic diplegia is a condition, not a disease. And though it has yet to be proven conclusively one way or another, it is said by some that genetic susceptibility in family heredity may also play a part in spastic diplegia and other forms of spastic cerebral palsy. However, the medical community also knows that no form of CP is itself genetic. A congenital disorder is a medical condition or defect that is present at or before birth (for example, congenital heart disease). ... In medicine, transmission is the passing of a disease from an infected individual or group to a previously uninfected individual or group. ... The term disease refers to an abnormal condition of an organism that impairs function. ... Heredity (the adjective is hereditary) is the transfer of characteristics from parent to offspring through their genes, or the transfer of a title, style or social status through the social convention known as inheritance (for example, a Hereditary Title may be passed down according to relevant customs and/or laws). ...


Above the hips, persons with spastic diplegia typically retain normal or near-normal muscle tone and range of motion, though some lesser spasticity may also affect the upper body, such as the trunk and arms, depending on the severity of the condition in the individual. Additionally, because leg tightness often leads to instability in ambulation, extra muscle tension usually develops in the upper body, shoulders, and arms due to compensatory stabilization movements, regardless of the fact that the upper body itself is not directly affected by the condition. Meanwhile, lower-extremity spasticity in spastic diplegia is rarely so great as to totally prevent ambulation — i.e., most people with the condition can walk — but the main difference between spastic diplegia and a normal gait pattern is that spastic diplegia does result in the signature "scissor gait" that some able-bodied people might tend to confuse with the effects of drunkenness, multiple sclerosis or another nerve disease. Muscle tone is the continuous and passive partial contraction of the muscles. ... Range of motion or (ROM), as used in the medical and weightlifting communities, is the achievable distance between the flexed position and the extended position of a particular joint or muscle group, or more precisely, the measurement of that distance. ... Walking is considered a form of human locomotion Walking is the main form of animal locomotion on land, distinguished from running and crawling. ... A gait can refer to: a particular way or manner of moving on foot: walking and running are the two basic human gaits; see also gait analysis and Gait (human). ... Persons suffering from peripheral neuropathy experience numbness and tingling in their hands and feet. ... The Drunkenness of Noah by Giovanni Bellini Drunkenness, in its most common usage, is the state of being intoxicated by consumption of ethyl alcohol to a degree that mental and physical facilities are noticeably impaired. ... Neurology is a branch of medicine dealing with disorders of the central and peripheral nervous systems. ...


Terminology

Socially, it should be noted that although the term "spastic" technically describes the attribute of spasticity in spastic cerebral palsy and was originally an acceptable and common term to use in both self-description and in description by others, it has since gained more notoriety as a pejorative, particularly when used in pop culture to insult able-bodied people when they seem overly anxious or unskilled in sports (see also the article spazz). In 1952 a UK charitable organization with a membership mainly of those with spastic CP was formed; this organization called itself The Spastics Society. However, the charity changed its name to Scope in 1994 due to the term spastic having become enough of a pejorative to warrant the name change. Spasticity is a disorder of the bodys motor system in which certain muscles are continuously contracted. ... It has been suggested that this article or section be merged with pejoration. ... Popular culture, or pop culture, is the vernacular (peoples) culture that prevails in a modern society. ... Spazz is a pejorative slang term used most often to refer to overly-anxious, tense, or worried performers or athletes (e. ... 1952 (MCMLII) was a Leap year starting on Tuesday (link will take you to calendar). ... A charitable organization (also known as a charity) is a trust, company or unincorporated association established for charitable purposes only. ... SCOPE is a UK based charity for disabled people in England and Wales. ... 1994 (MCMXCIV) was a common year starting on Saturday of the Gregorian calendar, and was designated as the International Year of the Family and the International Year of the Sport and the Olympic Ideal by United Nations. ...


Treatment

Muscle stretching, range of motion exercises, yoga, contact improvisation, modern dance, resistance training, and other physical activity regimens are often utilized by those with spastic CP to help prevent contractures and reduce the severity of symptoms. Some places within the United States have also issued medical marijuana to help treat spasticity. Range of motion or (ROM), as used in the medical and weightlifting communities, is the achievable distance between the flexed position and the extended position of a particular joint or muscle group, or more precisely, the measurement of that distance. ... Statue of Shiva performing Yogic meditation Yoga (Devanagari: योग) is a Sanskrit word that has a wide range of different meanings. ... Contact Improvisation (CI) is a dance technique in which points of physical contact provide the starting point for movement improvisation and exploration. ... Modern dance is a dance form developed in the early 20th century. ... Resistance training has two different, sometimes confused meanings - a more broad meaning that refers to any training that uses a resistance to the force of muscular contraction (better termed strength training), and elastic or hydraulic resistance, which refers to a specific type of strength training that uses elastic or hydraulic... Contracture can refer to: Dupuytrens contracture Volkmanns contracture Capsular contracture This is a disambiguation page: a list of articles associated with the same title. ... Cannabis sativa extract. ...


Major clinical treatments for spastic diplegia are:

  • baclofen (and its derivatives), a gamma amino butyric acid substitute injected into the spinal fluid for trial, and thereafter administered either orally or via an intrathecal pump;
  • phenol, injected selectively into the over-firing nerves in the legs on the muscle end to reduce spasticity in their corresponding muscles;
  • botox, injected directly into the spastic muscles;
  • orthopedic surgery to release the spastic muscles from their hypertonic state, a usually temporary result because of the source of the spasticity being in the nerves, not the muscles; and,
  • Rhizotomy, a neurosurgery directly targeting and eliminating (cutting) the over-firing nerve rootlets and leaving the properly-firing ones intact, thereby permanently eliminating the spasticity but compelling the person to re-strengthen muscles that will have been severely weakened by the loss of the spasticity.

Baclofen (brand names Kemstro® and Lioresal®) is a derivative of gamma-aminobutyric acid, and is an agonist specific to mammalian but not fruit fly (Drosophila) GABAB receptors[1][2]. It is used for the treatment of spastic movement, especially in instances of spinal cord injury, spastic diplegia and multiple sclerosis. ... Intrathecal pump is a medical device used to delivery very small quantities of medications to the spinal fluid. ... Phenol, also known under an older name of carbolic acid, is a colourless crystalline solid with a typical sweet tarry odor. ... Botulin toxin or botox is the toxic compound produced by the bacterium Clostridium botulinum. ... This fracture of the lower cervical vertebrae, known as a teardrop fracture is one of the conditions treated by orthopaedic surgeons. ... This article or section does not cite its references or sources. ... Insertion of an electrode during neurosurgery for Parkinsons disease. ... Nerve roots can refer to: Dorsal root Ventral root Category: ...

References

GPnotebook is a British medical database for general practitioners (GPs. ...

See also


  Results from FactBites:
 
Cerebral Palsy Source - Spastic Diplegia (484 words)
Spastic diplegia cerebral palsy is caused by brain damage in the outer layer of the brain, the cerebral cortex.
Spastic diplegia cerebral palsy affects nearly 70 to 80 percent of patients and is the most common form of cerebral palsy.
Patients with spastic diplegia cerebral palsy are typically characterized by a crouched gait.
Spastic diplegia - Wikipedia, the free encyclopedia (399 words)
Spastic diplegia refers to a type of cerebral palsy that is a neuromuscular condition of hypertonia and spasticity in the muscles of the lower extremities, usually those of the legs, hips and pelvis.
Spasticity in the legs is rarely so great as to totally prevent ambulation — i.e., most people with spastic diplegia can walk — but regardless, spastic diplega does result in the signature "scissor gait" that some able-bodied people might tend to confuse with the effects of drunkenness.
This damage is usually caused by asphyxia, hypoxia of the brain, premature birth, birth trauma, hematoma in the brain, or the presence of certain maternal infections during pregnancy.
  More results at FactBites »


 

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