Spasticity

What Is Spasticity?

Spasticity is a constant tightening or spasming of muscles. It most commonly affects a child’s limbs, hands, feet or face. Spasticity is a sign that there’s damage to nerve pathways in a child’s brain or spinal cord (central nervous system) that control muscle movements. Spasticity can be painful and affect your child’s ability to move, speak and swallow.

What Causes Spasticity in Children?

Certain neurologic disorders can damage nerve pathways, causing spasticity. These conditions include: 

• Brain tumors
• Central nervous system tumors
• Cerebral palsy
• Hereditary spastic paraplegias
• Multiple sclerosis 
• Spinal conditions, including tumors and spinal cord injuries
• Stroke
• Traumatic brain injury (TBI)

Genetic and Metabolic Disorders That Cause Spasticity in Children

Gene changes (mutations) can cause inherited conditions and metabolic disorders that cause spasticity. These genetic and metabolic disorders include:

• Hereditary spastic paraplegia
• Leukodystrophies, including adrenoleukodystrophy and Krabbe disease
• Phenylketonuria (PKU)

What Are the Signs and Symptoms of Pediatric Spasticity? 

Spasticity causes muscles to become overly tight. It’s a chronic symptom, meaning spasticity is always occurring. It doesn’t come and go. A child may have:

• Clonus: Repetitive, rapid muscle contractions or spasms
• Difficulty speaking or swallowing: Facial muscle contractures affect a child’s ability to swallow (dysphagia) or speak (speech impairments)
• Exaggerated deep-tendon reflexes (hyperreflexia): Muscles have a more intense, overactive reflex response 
• Hypertonicity (high muscle tone): Muscles are constantly contracted, tight or stiff, and unable to relax
• Joint contractures: Contracted muscles keep joints like elbows and fingers in a frozen or locked position
• Scissoring: Involuntary muscle movements cause a child’s legs to cross when walking

How Is Pediatric Spasticity Diagnosed?

Pediatric neurologists at Lurie Children’s specialize in disorders that cause spasticity. During a physical exam, a provider will move your child’s limbs to assess muscle tone and movements. A child with a previously diagnosed condition that’s known to cause spasticity may not need additional tests. 

If the cause of spasticity is unclear, your child may receive: 

• Brain MRI to look for brain or spinal cord issues 
• Genetic screening to check for genetic and metabolic conditions 

How Is Pediatric Spasticity Treated?

Pediatric neurologists at Lurie Children’s offer comprehensive treatments to relax your child’s muscles, helping to relieve pain and stiffness. Our team customizes a treatment plan based on your child’s unique diagnosis and needs. 

Medications for spasticity

Certain medications relax muscles, while others target nerve-signaling patterns to ease muscle spasms. Depending on your child’s needs, they may take these daily medications orally or through a gastrostomy tube. 

Pediatric neurosurgeons at Lurie Children’s are also experts at placing intrathecal baclofen pumps into a child’s belly. The pump delivers baclofen, a muscle relaxant, directly into your child’s spinal canal. The medication helps to relieve severe muscle tightness and stiffness. 

Medications that treat spasticity include:

• Baclofen
• Clonazepam 
• Dantrolene sodium
• Diazepam 
• Gabapentin
• Tizanidine

Botulin toxin injections for spasticity

Your child’s provider may inject botulinum toxin (Botox®) into spastic muscles to relieve spasms and tightness. These injections can help for three to 12 months, depending on the child. Most children receive this injection while taking medications and receiving other treatments. 

Surgical treatments for spasticity

Children who have severe spasticity that affects mobility or causes extreme pain may benefit from surgery. We offer:

• Selective dorsal rhizotomy: A pediatric neurosurgeon cuts sensory nerve roots in the lower spinal cord to ease muscle spasticity in the legs. 
• Contracture release surgery: A pediatric orthopedic surgeon performs contracture release surgery to ease tension on joints that are frozen from tight muscles and tendons. 

Nonsurgical treatments for spasticity

Lurie Children’s offers comprehensive services for children with spasticity, including:

• Bone Health Program, to help children at risk for low bone density and fractures due to limited mobility and weight-bearing activities  
• Orthotics, such as leg braces and devices to aid mobility, stability and function
• Rehabilitative services, including outpatient physical therapy and occupational therapy, or inpatient rehabilitation at Shirley Ryan AbilityLab
• Speech therapy to aid speech and swallowing 

What Is Lurie Children’s Approach to Caring for Children With Spasticity?

Lurie Children’s is the only pediatric center in the region with a Complex Movement Disorders Program providing integrated care for children with spasticity. Our experts partner with your family to ease your child’s symptoms and help them more fully engage in life. 

Your child benefits from:

• Deep expertise: Your child receives care from the only pediatric neurologists in the Chicago region who have advanced fellowship training in pediatric movement disorders. 
• Nationally recognized care: Our pediatric neurology and neurosurgery programs are among the top 10 in the country, as rated by U.S. News & World Report.
• Dedicated programs: Children with conditions like cerebral palsy and MS that cause spasticity receive comprehensive services at dedicated clinics. 
• Neurogenetic testing and counseling: Genetic counselors assist patients and families at risk for genetic disorders that cause spasticity. 
• Research and clinical trials: We’re active in national pediatric neurology research and clinical trials to find new ways to manage spasticity in children. Your child may be able to try promising new therapies still in development.

Lurie Children’s Complex Movement Disorders Program

A team of specialists at the Lurie Children’s Complex Movement Disorders Program provides comprehensive care for common and rare conditions that cause spasticity in children. Your child benefits from a personalized treatment plan that eases spasticity and pain. We partner with you to improve your child’s mobility and independence. 

Learn more about our Complex Movement Disorders Program.