Spasticity typically occurs in patients following cerebral palsy, stroke, brain injury (trauma and other causes, e.g. anoxia, post-neurosurgery), spinal cord injury, multiple sclerosis and other neurological diseases.
- Cerebral palsy is a brain damage which occurs either before birth, or during infancy (up to the age of 2 y.o.). It may be due to varied causes: temporary lack of blood supply to the brain (anoxia), infection of the brain (encephalitis), vascular malformation in the brain, and bleeding inside the brain whatever the cause may be (malformation, brain injury). It is non-progressive.
It is estimated to occur in 0.2% of births. This figure has remained stable over the years, despite a decrease in the rate of infantile mortality (HIMMELMANN HIMMELMANN K
Handbook of Clinical Neurology, Pediatric Neurology Part I. Dulac O, Lassonde M, Sarnat HB, eds Vol. 111 (3rd series)
2010). It is more frequent in premature children.
Depending on which part of the brain is involved, it can produce spasticity of one, two, three or all four limbs. Most often it affects only one side of the body (hemiplegia), or all four limbs (quadriplegia, or quadriparesis).
- In adults, stroke is the main cause of spasticity. Vascular malformations, and aging of the blood vessels (arterio-sclerosis) may produce bleeding or thrombosis of some arteries within the brain, resulting in permanent damage to part of the cerebral tissue. It is estimated that 20% of patients with a stroke suffer from spasticity (but these figures may be underestimated, as many patients with mild spasticity require little or no treatment, and do not appear in spastic registries).
- Head injury can result in brain damage (cerebro-lesion). Severe spasticity may develop within a few months of the injury.
- Tetraplegia caused by a spinal cord lesion may cause spasticity, predominantly in the lower limbs. In cases where the tetraplegia is incomplete (partial injury of the spinal cord), spasticity may be important also in the upper limbs. Tetraplegia is most often traumatic (dive in shallow waters, fall from a height, motor vehicle accident), but can also be due to vascular or infectious causes.
- Other conditions such as multiple sclerosis may be associated with spasticity
