Muscle Tone Management
Explanation, Medications, Therapies
Understanding Abnormal Muscle Tone
The first image shows a child with spasticity in the legs, the second image shows a child with dystonia in the arms and hands, and the third shows a child with hypotonia requiring support to hold her head upright.
Abnormal Tone in AGS
AGS causes abnormal tone and movement disorders due to neurological injury. These disorders, including dystonia, spasticity, and hypotonia, affect muscle tone and can impact movement and motor function in children with AGS. As AGS can present differently in each individual, symptoms may vary in severity and affect different muscle groups. Families may benefit from looking to Cerebral Palsy as a model for information about management and treatment.
Spasticity, Dystonia, and Hypotonia
Spasticity
A condition in which there is an abnormal increase in muscle tone or stiffness of muscle, which might interfere with movement, speech, or be associated with discomfort or pain.
Dystonia
A movement disorder characterized by involuntary muscle contractions that cause slow repetitive movements or abnormal postures.
Hypotonia
A term that describes decreased muscle tone. It is not the same as muscle weakness, although the two conditions can happen at the same time.
Managing Muscle Tone in Disabled Children
There are various approaches to managing muscle tone, and we recommend referring to this resource for a comprehensive understanding of their evidence-based effectiveness.
Physical Therapy
Physical therapy is a common method used to manage spasticity and dystonia in children. It involves exercises and stretches that help improve muscle control and flexibility.
Botulinum Toxin and Phenol Injections
Botulinum toxin, commonly known as Botox, is a medication that can be injected directly into muscles to temporarily weaken them. Phenol is a chemical that can be used to temporarily deaden nerves in a muscle, which can reduce spasticity. Either of these can help reduce spasticity and improve range of motion. Injections are usually given every few months under sedation and may have side effects such as pain, bruising, and weakness.
Medications
Medications such as Baclofen and Diazepam can be used to reduce spasticity and muscle rigidity. However, they may have side effects such as drowsiness and weakness. Usually taken orally, baclofen can also be delivered by a medical device that is surgically implanted into the abdomen to deliver medication directly into the spinal cord.
Surgeries
As a last resort, surgical interventions may be necessary to release tight muscles and improve mobility. Surgeries are usually considered when other treatments have not been effective. Joint contractures, hip dislocations, scoliosis, and deformed extremities may result from unmanaged spasticity and dystonia.
Conclusion
While managing abnormal muscle tone can be challenging for disabled children and their families, there are various methods available to manage these conditions and improve quality of life. Consult with your doctor to determine the best course of action for your child.