I. Hypotension

II. Hypertension

1. Spasticity.
2. Extrapyramidal rigidity.
3. The phenomenon of opposition (gegenhalten).
4. catatonic rigidity.
5. Decortication and decerebration rigidity. Hormetonia.
6. Myotonia.
7. Muscle tension (Stiffness).
8. Reflex hypertension: muscular-tonic syndromes in diseases of the joints, muscles and spine; stiffness of the neck muscles with meningitis; increased muscle tone in peripheral injury.
9. Other types of muscle hypertension.
10. Psychogenic muscular hypertension.

I. Hypotension

Hypotension is manifested by a decrease in muscle tone below the normal physiological level and is most characteristic of damage at the spinal muscular level, but can also be observed in diseases of the cerebellum and some extrapyramidal disorders, especially chorea. The range of motion in the joints (their overextension) and the amplitude of passive excursions (especially in children) increase. With atony, the predetermined posture of the limb is not maintained.

Diseases affecting the segmental level nervous system, include poliomyelitis, progressive spinal amyotrophy, syringomyelia, neuropathies and polyneuropathy, and other diseases that involve the anterior horns, posterior columns, roots, and peripheral nerves. In the acute phase of the transverse lesion spinal cord spinal shock develops, in which the activity of the cells of the anterior horns of the spinal cord and spinal reflexes is temporarily inhibited below the level of the lesion. The upper level of the spinal axis, the dysfunction of which can lead to atony, is the caudal parts of the brainstem, the involvement of which in deep coma is accompanied by complete atony and portends a poor outcome of the coma.

Muscle tone may be reduced in cerebellar lesions different type, chorea, akinetic epileptic seizures, deep sleep, during fainting, states of disturbed consciousness (fainting, metabolic coma) and immediately after death.

With cataplexy attacks, usually associated with narcolepsy, muscle atony develops in addition to weakness. Seizures are more often provoked by emotional stimuli and are usually accompanied by other manifestations of polysymptomatic narcolepsy. Rarely, cataplexy is a manifestation of a midbrain tumor. In the most acute (“shock”) phase of a stroke, a paralyzed limb sometimes reveals hypotension.

A separate problem is hypotension in infants(“flaccid child”), the causes of which are very diverse (stroke, Down syndrome, Prader-Willi syndrome, birth trauma, spinal muscular atrophy, congenital neuropathy with hypomyelination, congenital myasthenic syndromes, infant botulism, congenital myopathy, benign congenital hypotension).

Rarely, post-stroke hemiparesis (with an isolated lesion of the lentiform nucleus) is accompanied by a decrease in muscle tone.

II. Hypertension

spasticity

Spasticity develops with any lesions of the cortical (upper) motor neuron and (mainly) the cortico-spinal (pyramidal) tract. In the genesis of spasticity, an imbalance of inhibitory and facilitating influences from the reticular formation of the midbrain and brain stem is important, followed by an imbalance of alpha and gamma motor neurons of the spinal cord. Often the phenomenon of "jackknife" is revealed. The degree of hypertonicity can vary from mild to extremely pronounced, when the doctor is unable to overcome spasticity. Spasticity is accompanied by tendon hyperreflexia and pathological reflexes, clonuses and, sometimes, protective reflexes and pathological synkinesis, as well as a decrease in superficial reflexes.

With hemiparesis or hemiplegia of cerebral origin, spasticity is most pronounced in the flexor muscles on the arms and extensor muscles on the legs. In bilateral cerebral (and some spinal) injuries, spasticity in the adductor muscles of the thigh leads to characteristic dysbasia. With relatively severe spinal injuries in the legs, flexor muscle spasm, reflexes of spinal automatism and flexor paraplegia are more often formed.

Extrapyramidal rigidity

Extrapyramidal rigidity is observed in diseases and injuries affecting the basal ganglia or their connections with the midbrain and the reticular formation of the brain stem. An increase in tone applies to both flexors and extensors (increased muscle tone according to the plastic type); resistance to passive movements is noted during movements of the limbs in all directions. The severity of rigidity may be different in the proximal and distal limbs, in the upper or lower body, as well as on the right or left half of it. At the same time, the phenomenon of "gear wheel" is often observed.

The main causes of extrapyramidal rigidity: rigidity of this type is most often observed in Parkinson's disease and other parkinsonian syndromes (vascular, toxic, hypoxic, postencephalitic, post-traumatic, and others). In this case, there is a tendency to gradually involve all muscles, but the muscles of the neck, trunk and flexors are affected more coarsely. Muscle rigidity is combined here with symptoms of hypokinesia and (or) low-frequency rest tremor (4-6 Hz). Postural disorders of varying severity are also characteristic. Rigidity on one side of the body increases with active movements of the contralateral limbs.

Less commonly, plastic hypertonicity is observed in tonic forms of dystonic syndromes (debut of generalized dystonia, tonic form of spastic torticollis, dystonia of the foot, etc.). This type of hypertonicity sometimes causes serious difficulties in making a syndromic differential diagnosis (parkinson's syndrome, dystonic syndrome, pyramidal syndrome). The most reliable way to recognize dystonia is to analyze its dynamics.

Dystonia (a term intended not to refer to muscle tone, but to a specific type of hyperkinesis) manifests itself muscle contractions, which lead to characteristic postural (dystonic) phenomena.

The phenomenon of opposition

The phenomenon of opposition or gegenhalten is manifested by increasing resistance to any passive movements in all directions. The doctor at the same time makes increasing efforts to overcome resistance.

Main reasons: the phenomenon is observed with damage to the corticospinal or mixed (corticospinal and extrapyramidal) pathways in the anterior (frontal) parts of the brain. The predominance of this symptom (as well as the grasping reflex) on one hand indicates a bilateral lesion of the frontal lobes with a predominance of damage in the contralateral hemisphere (metabolic, vascular, degenerative and other pathological processes).

Catatonic rigidity

There is no generally accepted definition of catatonia. This form of increased muscle tone is similar in many respects to extrapyramidal rigidity and probably has overlapping pathophysiological mechanisms with it. The phenomenon of "wax flexibility", given "freezing postures" (catalepsy), "strange motor skills" against the background of gross mental disorders in the picture of schizophrenia are characteristic. Catatonia is a syndrome that has not yet received a clear conceptual design. It is unusual in that it blurs the line between psychiatric and neurological disorders.

Main reasons: catatonia syndrome has been described in non-convulsive forms of status epilepticus, as well as in some gross organic brain lesions (brain tumor, diabetic ketoacidosis, hepatic encephalopathy), which, however, needs further clarification. Usually it is characteristic of schizophrenia. Within schizophrenia, catatonia presents with a complex of symptoms including mutism, psychosis, and unusual motor activity ranging from agitated outbursts to stupor. Concomitant manifestations: negativism, echolalia, echopraxia, stereotypes, mannerisms, automatic obedience.

Decortication and decerebration rigidity

Decerebrate rigidity is manifested by constant rigidity in all extensors (anti-gravity muscles), which can sometimes intensify (spontaneously or with painful stimulation in a patient in a coma), manifested by forced extension of the arms and legs, their adduction, slight pronation and trismus. Decortication rigidity is manifested by flexion of the elbow and wrist joints with extension of the legs and feet. Decerebrate rigidity in patients in a coma ("extensor pathological postures", "extensor postural reactions") has a worse prognosis compared with decortication rigidity ("flexor pathological postures").

Similar generalized rigidity or spasticity with retraction (extension) of the neck and sometimes the trunk (opisthotonus) can be observed in meningitis or meningism, the tonic phase of an epileptic seizure, and in processes in the posterior cranial fossa that occur with intracranial hypertension.

A variant of extensor and flexor spasms in a patient in a coma is a rapidly changing muscle tone in the limbs (hormetonia) in patients in the acute phase of hemorrhagic stroke.

Myotonia

Congenital and acquired types of myotonia, myotonic dystrophy, paramyotonia and, sometimes, myxedema are manifested by increased muscle tone, which, as a rule, is detected not during passive movements, but after active voluntary contraction. With paramyotonia, a pronounced increase in muscle tone is provoked by cold. Myotonia is detected in the test of clenching the fingers into a fist, manifested by delayed relaxation of spasmodic muscles; repeated movements lead to the gradual restoration of normal movements. Electrical stimulation of the muscles causes increased contraction and delayed relaxation (the so-called myotonic response). Percussion (hit with a hammer) of the tongue or thenar reveals a characteristic myotonic phenomenon - a “dimple” at the site of impact and adduction of the thumb with delayed muscle relaxation. Muscles may be hypertrophied.

Muscle tension (stiffness)

Muscle tension is a special group of syndromes, associated by its pathogenesis mainly with spinal (interneurons) or peripheral damage (syndromes of "hyperactivity of motor units").

Isaacs syndrome (neuromyotonia, pseudomyotonia) is manifested by rigidity, which first appears in the distal extremities and gradually spreads to the proximal, axial and other muscles (face, bulbar muscles) with difficulty in movements, dysbasia and constant myokymia in the affected muscles.

Stiff-person syndrome, on the contrary, begins with rigidity of the axial and proximal muscles (mainly the muscles pelvic girdle and trunk) and is accompanied by characteristic spasms of great intensity in response to external stimuli of various modalities (enhanced startle reaction).

Close to this group of muscular-tonic disorders are McArdle's disease, paroxysmal myoglobulinemia, tetanus (tetanus).

Tetanus is an infectious disease characterized by generalized muscle rigidity, although the muscles of the face and mandible. Against this background, characteristic muscle spasms arising spontaneously or in response to tactile, auditory, visual and other stimuli. There is usually severe generalized rigidity between spasms.

"Reflex" rigidity

"Reflex" rigidity combines syndromes of muscle-tonic tension in response to pain irritation in diseases of the joints, spine and muscles (for example, protective muscle tension in appendicitis; myofascial syndromes; cervicogenic headaches; other vertebrogenic syndromes; increased muscle tone in peripheral injury).

Other types of muscle hypertension include muscle stiffness during an epileptic seizure, tetany, and some other conditions.

High muscle tone is observed during the tonic phase of generalized seizures. Sometimes there are purely tonic epileptic seizures without a clonic phase. The pathophysiology of this hypertonicity is not completely clear.

Tetany is manifested by a syndrome of increased neuromuscular excitability (symptoms of Chvostek, Trousseau, Erb, etc.), carpo-pedal spasms, paresthesias. More common variants of latent tetany against the background of hyperventilation and other psychovegetative disorders. A rarer cause is endocrinopathy (hypoparathyroidism).

Psychogenic hypertension

Psychogenic hypertension is most clearly manifested in the classic picture of a psychogenic (hysterical) seizure (pseudo-seizure) with the formation of a "hysterical arc", with a pseudodystonic variant of psychogenic hyperkinesis, and also (less often) in the picture of lower pseudoparaparesis with pseudohypertonia in the feet.

Muscle tone is one of the physiological properties of the human body. The nature of this condition has not yet been established, but there are several theories that experts adhere to. Muscle tension at rest can change under the influence of external factors or diseases of the nervous system. There are two types of pathology: hypertonicity and hypotonicity. In the article we will consider in detail their symptoms and treatment.

The value of muscle tone

Tonic muscle tension is a normal physiological state of the human body, which is carried out at the reflex level. Without it, it would be impossible to perform many movements, as well as maintain the position of the body. Muscle tone keeps the body in readiness for active action. This is its main purpose.

What is the mechanism of muscle work with normal tone? If all the fibers of the tissue are involved in the movement, then at rest they replace each other. While some are tense, others are resting. Interestingly, the process is directly affected by the psycho-emotional state of a person. For example, a decrease in muscle tone leads to a decrease in performance and is observed mainly during sleep. The condition is accompanied by natural calmness: excessive excitement is significantly reduced.

The regulation of muscle tone is carried out with the help of alpha and gamma motor neurons, afferent fibers and spindles. The impulses come from the brain. The cerebellum, the midbrain (the red nucleus, the black substance, the quadrigemina) are responsible for maintaining muscle tone. If the neurons responsible for tonic tension are damaged, its disturbances occur: hypotension or hypertension of the muscles.

Diagnosis in adults

A change in tone can occur for various reasons. Most often, these are diseases of the nervous system or a complex psycho-emotional state. A neuropathologist or orthopedist deals with the problem of muscle tone disorders. To correctly diagnose, conduct an examination. Muscle tension is assessed in a relaxed state and during passive movements using special tests: dropping the head, supination-pronation, swinging the legs, shaking the shoulders, and others.

Examination is quite difficult: not every patient can completely relax. At the same time, the qualification of the doctor is also important - the speed of passive movements affects the assessment of the condition. External factors can also distort the results: muscle tone changes under the influence of temperature and mental state. The most difficult situations require re-examination.

Tonus in children up to a year

In the womb, the fetus is located very closely, so all the muscles are in constant tension. After birth, the baby has physiological hypertonicity. In this case, the head is thrown back, and the legs and arms are brought to the body.

Which muscles are tense is affected by the position of the baby in the womb and in the birth process. For example, with facial presentation, there is an increased tone of the neck (the newborn throws his head back). In the “forward buttocks” position, the child’s legs are spread apart, forming an angle of 90 ° between them. Lying on the bed, the baby tries to take the usual fetal position.

Diagnosis of tone in babies

When conducting an examination, a pediatrician or neuropathologist assesses the state of the child's muscle tone according to the following signs:

• At 1 month, the baby, lying on his stomach, tries to raise his head and holds it for a few seconds. Legs make bending movements, as if crawling. If you put your hand under your feet, he will push off from it.
• By 3 months, the child holds his head confidently. If you raise it in a vertical position, the legs will make movements, as when walking. The child can lean on the foot. If you put him on his back and pull the handles, he will be pulled up by his own strength.
• Up to 6 months, the baby rolls over from his stomach to his back, tries to get on all fours, holds small objects in his hands.
• By the age of one, the child sits confidently, tries to walk with support, and develops on his own.

If the baby cannot perform one of the listed actions due to excessive tension or, conversely, muscle weakness, they speak of pathology. Additionally, the doctor evaluates the symmetry of the tone. To do this, alternately bend and unbend the arms and legs of the child. Watch for active movements different provisions body. A deviation from the norm is hypotonicity, hypertonicity, which persists even during sleep, and muscle dystonia.

Types of hypertonicity and the causes of its development

Increased muscle tone can manifest itself in different ways. Experts distinguish:

• Spasticity - develops due to craniocerebral and spinal injuries, meningitis, encephalopathy, cerebral palsy, multiple sclerosis, stroke. It is characterized by uneven distribution of hypertonicity, when only certain muscle groups are subjected to spasm.
• Rigidity is a sharp increase in tone skeletal muscle, arises as a result of diseases of the nervous system, the poisoning effects of certain poisons.
• Gegenhalten - a sharply increasing muscle resistance during passive movements of any type. It occurs in connection with the defeat of the mixed or corticospinal tracts in the frontal regions of the brain.
• Myotonia - characterized by slow relaxation of tense muscles after active movements.
• Psychogenic hypertension - during a seizure, a "hysterical arc" is formed.

In children, the cause of the development of hypertonicity is birth trauma, hypoxia in childbirth, damage to the nervous system and brain, meningitis, excessive excitability or hyperactivity.

Symptoms of hypertonicity

Hypertension of the muscles is expressed in their excessive tension in a relaxed state. The disease can be identified by the following signs:

• decreased motor function, muscle stiffness;
• seals;
• feeling of constant tension;
• soreness;
• spasms;
• significant muscle resistance during passive movements;
• in children, tearfulness, increased nervous excitability, increased muscle resistance when repeating flexion-extensor movements;
• in a vertical position with support on the legs, the baby presses the feet, standing on tiptoe;
• slowdown motor development child (does not sit down, does not crawl, does not walk at the right age).

It is not difficult to notice hypertonicity in an adult or a child, especially in the middle and severe stages. The gait changes, actions are carried out stiffly, with great difficulty. At the same time, babies are clamped and tense, often scream and sleep poorly, react painfully to any, even minor, noise. After eating, profuse regurgitation occurs.

Causes and symptoms of muscle hypotension

Weak muscle tone is characterized by low tissue tension in a relaxed state, which makes it difficult to actuate them. This happens mainly due to damage or disease of the spinal cord, cerebellum or extrapyramidal disorders and cerebellar damage. There are also attacks, during which the muscle tone temporarily decreases. This occurs in the acute phase of a stroke or in a midbrain tumor.

Weak muscle tone in children is less common than hypertension. Its appearance can be triggered by prematurity, slow brain development, damage to peripheral nerves during the birth process, congenital malformations, Down syndrome, rickets.

Symptoms of muscle hypotonia in babies are:

• lethargy, overly relaxed state;
• respiratory failure, inability to swallow, suck;
• weak motor activity;
• excessive sleepiness, poor weight gain.

Violation of muscle tone in the direction of its decrease can be observed in adulthood. Various diseases usually lead to this: muscle dystrophy, sepsis, rickets, meningitis, Sandifer's syndrome. The condition is accompanied by physical weakness, reduced resistance to passive movements. When flexed, the joints unbend on their own, the muscles feel soft to the touch.

Muscular dystonia in adults and children

With muscle dystonia, uneven tone is observed. At the same time, there are signs of both hypotension and hypertension. The main symptoms of dystonia in children and adults are:

• excessive tension of certain muscles and relaxation of others;
• spastic contractions;
• legs or arms;
• fast or slow movements of certain parts of the body.

A condition develops in connection with genetic, infectious diseases, birth injuries, severe intoxications.

Treatment

Muscle tone is important to normalize in time, especially in childhood. The progression of symptoms leads to impaired movement, scoliosis, cerebral palsy, and delayed development. There are several treatment methods:

• massage for muscle tone good results, for this, the muscles are stroked, kneaded, stretched, their strength is trained, making physiological movements (flexion-extension);
• physiotherapy, including in water;
• physiotherapy: electrophoresis, ultrasound, treatment with heat, water and mud;
• in difficult cases, medications are used, among which vitamins of group B, dibazol, mydocalm can be prescribed.

With hypertonicity, the muscles try to relax with the help of stroking, healing injuries, light massage, stretching. In hypotension, on the contrary, they stimulate motor movements performing muscle tone exercises. significantly improves the patient's condition.

Violation of muscle tone is a common problem in children of the first year of life and adults with diseases of the nervous system. It is quite easy to treat with the help of massages, less often - medicines. Mobility returns to normal, and there is no trace of the problem. The main thing is to start treatment on time, preventing serious violations and deviations in the development of the skeleton and muscles.

Muscle tone - involuntary, constantly changing in intensity muscle tension, not accompanied by a motor effect. Muscle tone creates preparation for movement, provides resistance and elasticity of muscles. Maintain balance and posture. Muscle tone has 2 components - plastic and reflex. Plastic tone is muscle tension, its turgor, which is preserved under conditions of denervation. This term defines the tone of individual muscle cells, depending on the characteristics of their structure, the exchange of in-in, blood and lymph circulation, the content of the comp. fabrics.

Reflex tone - reflex muscle tension caused by its stretching, i.e. stimulation of proprioreceptors. Muscle tone is influenced by the spinal reflex apparatus, afferent innervation, reticular formation, vestibular centers, cerebellum, red nucleus system, basal nuclei, etc. To judge the state of muscle tone, direct palpation of the muscles of segmental areas of the body is performed. However, the determining factor is the study of muscle tone through passive movements in the flexors and extensors, adductors and abductors. Hypotension and atony of muscles occurs when peripheral paralysis or paresis (violation of the efferent section of the reflex arc in case of damage to the nerve, root, cells of the anterior horn of the spinal cord), damage to the cerebellum, brain stem, corpus striatum and posterior cords of the spinal cord. Distinguish between spastic and plastic hypertension. Spast-th - increase. muscle tone in the flexors and pronators of the arm and in the extensor and adductors of the leg (with damage to the pyramidal tract). With spastic hypertension, during repeated movements of the limb, muscle tone does not change, and sometimes decreases, with plastic hypertension, muscle tone increases. With spastic hypertension, there is a symptom of a “penknife” (an obstacle to passive movement in the initial phase of the study), with plastic hypertension, a symptom of a “gear wheel” (feeling of tremors during the study of muscle tone in the limbs). Plastic hypertension is an increase in muscle tone, uniform in both flexors and extensors, in pronators and supinators.

2.7.Peripheral paralysis.

In periphral paralysis (PP), damage can involve the anterior horns, several anterior roots, and peripheral nerves. PP is characterized by: 1) hypotension and muscle atony. 2) hypo- and areflexia. 3) hypo- and muscle atrophy. 4) neurogenic muscular degeneration with the reaction of degeneration.

When the anterior horns are affected, the muscles innervated from this segment suffer. Often in atrophying muscles, rapid contractions of individual muscle fibers and their bundles are observed - fibrillar and fascicular twitches, due to irritation by the pathological process on dead neurons.

The defeat of the anterior roots gives the same picture. Damage to the plexus har-Xia periph with paralysis of one limb in combination with pain and anesthesia, as well as autonomic disorders in this limb. In case of damage to the periphery of the nerve, paralysis of the muscles of the inner nerves by this nerve is observed, in combination with sensory disturbances. Damage to many peripheral nerves leads to widespread sensory, motor and vegetative disorders, most often bilateral, mainly in the distal segments of the extremities. Patients complain of paresthesia and pain. Disturbances in the type of "socks" or "gloves", flaccid paralysis of muscles with atrophy, trophic disorders on the skin are revealed.

The musculoskeletal system consists of a huge number of muscles that actively contract and ensure the movement of people. They are very elastic and extensible fibers, consisting of muscle tissue. When exposed to nerve impulses, the process of contraction occurs. Muscles provide movement to various parts of our body, as well as the manifestation of emotions.
People have no problem performing a variety of movements from the simplest - wink and smile to complex ones. Proper muscle activity ensures not only mobility, but also the normality of all organs and systems, as well as the processes occurring in them. The nervous system regulates the work of all muscle tissues and is a link with the brain and spinal cord, and also takes an active part in the process of converting chemical energy into mechanical energy.

Tone

Prolonged work and heavy loads contribute to muscle fatigue. Due to injury, as well as various diseases of the nervous system, the proper functioning of muscle fibers is disrupted and muscle tone occurs.
Muscle tone is the uncontrolled tension of muscle fibers, which results in their contraction during the period of being in a relaxed state. The main pathological conditions are:

• muscle hypotension;

Hypotension

Hypotension is a pathological change in which muscle tone decreases. Often this condition is diagnosed not only in children, but also in people of the adult age category. Due to the occurrence of such a pathology, muscle fibers weaken, and eventually stop responding to impulses sent by the nervous system.

Symptoms

The main signs that indicate the presence of muscle hypotension are:

• severe weakness in the muscles;
• the occurrence of atony;
• decreased physical activity or its complete absence;
• problems with the breathing process;
• joint deformity;
• a person is not able to sit up on his own, he falls into a supine position.

Kinds

These changes can provoke more than a hundred diseases. As a result, there is a division into the following types:

• diffuse;
• local;

According to the degree of development of this condition, hypotension is divided into the following types:

• gradually developing;
• spicy.

The classification is also carried out in connection with the causal provoking occurrence of a decrease in muscle tone:

• congenital - develops as a result of genetic abnormalities;
• acquired - appears throughout life, due to the transfer of various systemic diseases.

Causes

Factors in the occurrence of muscle hypotonia can be both genetic and other types of diseases. The main ones are:

• Down syndrome;
• Martin-Bell syndrome;
• Rett syndrome;
• Canavan disease;
• Pituitary dwarfism;
• Menkes disease;
• dystrophic changes in muscles;
• leukodystrophy;
• atrophic processes in the spinal muscles;
• meningitis;
• polio;
• sepsis;
• myasthenia gravis;
• negative reaction to grafting;
• celiac disease;
• hypervitaminosis;
• jaundice;
• rickets.

Paralysis

Muscle paralysis is a pathological condition due to which there is a loss of important muscle functions necessary for motor activity. Muscle tone occurs due to conditions such as:

• myopathy;
• muscular dystonia;
• infectious diseases;
• tumor formation and hemorrhages in the brain and spinal cord;
• accidents and various injuries.

Paralysis is divided into two types:

• flaccid - this is a very strong decrease in the muscular torus, which leads to the death of muscle fibers;
• spastic - characterized by excessively increased muscle tone, in which a person is unable to independently control the movements of his body.

In addition to the above classification, there are individual diseases that are related to paralysis. The main ones are:

• Bell's palsy;
• bulbar paralysis;
• Erb's paralysis.

Bell's palsy

As a result various factors affecting our face, damage to the facial nerve may occur, which will lead to its paralysis. The main reasons are:

• hypothermia;
• malignant neoplasms;
• trauma and surgery.

The appearance of the disease brings with it many inconveniences and serious changes that reduce the quality of life and lead to disability. After a few weeks, there is a loss of function of some muscles, and then their complete paralysis occurs. As a result of such processes, a person cannot speak, eat and close his eyes completely during sleep. Very rarely there is a state of paralysis of all the muscles on both sides of the face.

bulbar palsy

This type of disease occurs due to damage to the brain stems and is characterized by a violation of the motor functions of the oral organs, pharynx and larynx. There are problems with speech, swallowing liquids and solid food. Breathing becomes difficult and suffocation and death can occur.
In medical practice, bulbar palsy is divided into two groups:

• spicy;
• progressive.

This type of paralysis is extremely rare, but once it occurs, it cannot be completely eliminated. As a result, the life expectancy of the patient can be several years.

Erb's palsy

This type often occurs when receiving a birth injury. brachial plexus. The fifth nerve of the spinal cord is damaged. Difficult childbirth can result in paralysis of the muscles of the shoulder and forearm. Such cases are rare in newborn babies, but still happen.
The child becomes restless, muscle tone decreases, problems arise with the respiratory system and movements of the injured limb, or rather, it is practically absent.

Paresis

Paresis is a condition in which there is a decrease in strength in the muscles.
The resulting paresis is characterized by the following features:

• when walking, a person rolls from foot to foot, like a duck;
• the motor activity of the limbs is difficult;
• the head and feet hang down when lifting the legs up;
• It is difficult for the patient to stand and sit.

Kinds

Depending on the location, paresis is divided into the following types:

• monoparesis - occurs in only one arm or leg;
• hemiparesis - one side of the limb is affected;
• paraparesis - localized only in both arms or legs;
• tetraparesis - all limbs are located.

Causes

Paresis often occurs due to the following factors:

• violation of the head and spinal blood flow;
• disseminated encephalomyelitis;
• abscesses in the brain and spinal cord;
• poisoning with various poisons;
• myasthenia gravis;
• botulism;
• epilepsy;
• diseases of motor neurons (amyotrophic sclerosis).

Diagnostics

To determine the factor that causes an increase or decrease in muscle tone in a medical institution, a number of the following diagnostic methods are carried out:

• collection of data about the patient and his entire family;
• examination of the affected areas by a specialist and checking for reflexes;
• CT scan;
• magnetic reflex tomography;
• general and biochemical blood test;
• genetic studies are carried out with hypotension;
• myelography;
• nerve conduction studies;
• biopsy muscle fiber from the area where changes in muscle tone are manifested.

For a thorough study of the causes of pathological changes occurring directly at the site of manifestation of muscle hypotonia, topical diagnostics are used. During its implementation, a detailed study is carried out:

• peripheral nerve;
• peripheral motor neuron in the spinal cord;
• cerebellum.

Diagnosis of paresis in addition to the above methods is carried out on a 5-point scale:

• 5 points - functions are not disturbed, there is no paresis;
• 4 points - slight decrease in muscle strength;
• 3 points - a significant decrease in muscle strength;
• 2 points - muscle contraction when it is impossible to resist gravity;
• 1 point - unproductive contraction of individual muscle bundles of the muscle;
• 0 points - lack of muscle strength.

Based on the results of the diagnostic measures carried out, a correct diagnosis will be made and an effective course of therapy will be prescribed, which will help get rid of this condition and restore lost functions.

Therapy

For the treatment of hypotonia, medications are used that will help cure the ailment that causes muscle weakness.
A massage complex is performed, with the help of active movements, weakened muscles are affected. Often, the following techniques are used during manipulation:

• tingling;
• rubbing;
• kneading;
• tingling.

Specialists in the field of massage during the procedure produce pressure on special points that will help increase muscle tone.
And also used therapeutic exercises. Performing a set of physical exercises helps to strengthen muscles and get rid of hypotension as quickly as possible.
Therapy for paralysis includes symptomatic treatment, and in parallel with it, therapeutic exercises, massage and reception are carried out. medicines. In addition to these measures, it is imperative to lay the affected areas of the body in the correct position.
Treatment of paresis, as well as paralysis and hypotension, is aimed at eradicating the disease that provokes its occurrence. Thermal procedures are also used in conjunction with massage. As a result of such manipulations, blood flow and tissue trophism improve. There is a restoration of the working capacity of the affected limbs.

Complications

Muscle hypotension can cause the appearance of various unpleasant processes in the human body, such as:

• metabolic disease;
• a set of excess body weight;
• spinal deformity.

The course of therapy for paralysis does not guarantee that all muscle functions will be fully restored. Such people need special care, because they can be completely or partially immobilized for a long period. Prolonged stay in the same position provokes the development of a number of the following problems:

• greatly increased or decreased blood pressure;
• deteriorating joint mobility;
• metabolic processes are disturbed;
• lungs are not fully functional;
• problems of the urinary system;
• disruption of the circulatory system;
• headaches and dizziness;
• fainting.

For such people, it is recommended to use special compression aids that will help avoid thrombosis, and it is also very important to maintain body hygiene so that bedsores do not occur.
With paresis, a persistent neurological defect occurs, which leads to violations of social and labor adaptation.

Prevention

To avoid such changes in the muscles, you need to monitor your health and take preventive measures, such as:

• complete rejection of bad habits (smoking, alcohol);
• walks in the open air;
• regular medical check-ups;
• get rid of emerging diseases as quickly as possible.

Video: PARESIS AND PARALYSIS. What is paresis? What is paralysis?

Muscle tone refers to physiological properties the human body, the nature of the impact of which is not fully understood by medicine. The transition from a state of rest to tension is possible under the influence of various factors, both external and internal, while taking into account diseases of a different nature, including diseases and malfunctions of the central nervous system.

Pathologies of muscle tone differ in types: hypotonicity and hypertonicity. Both manifestations are considered physiologically necessary for the normal functioning of the body. Muscle tension occurs subconsciously, on a reflex, which provides almost all types of movement, including maintaining the body in the desired position. Keeping a person in constant readiness for any action is main task muscle tone.

What is the difference between normal tone and disturbed tone

Many parents are concerned about the question of whether everything is fine with the health of their babies, what is the state of the support systems and organs of the child's body. In order to understand the level of muscle tone, it is important to have information about what changes may indicate a violation in the system.

• If there is an uneven distribution of tone relative to the location of the body, there are signs of dystonia on the face.
• The presence of one-sided tension in the baby's body against the background of relaxation of the other indicates that the baby has asymmetric disorders. This is additionally confirmed by the movements of the baby: turning in the direction of hypertonicity, the child bends to the other, while there is uneven skin folds on the buttocks and thighs.
• Constriction, with the inability to completely relax even at the time of sleep, indicates that the baby has muscle strain (hypertonicity). If the baby initially holds his head after birth, his fingers on the arms and legs are twisted intricately among themselves, a severe form of the disease is on the face.
• If the baby does not move properly, he looks lethargic, inactive, everything suggests that the baby is prone to a form of hypotension.

Decreased and increased muscle tone

Both increased and decreased muscle tone is a deviation from the norm and requires treatment of the disease. The cause of such deviations can be various diseases and malfunctions of the central nervous system.

Reduced tone can manifest itself against the background of atrophy of the musculoskeletal system, neonatal dystrophy, as a result of botulism, poliomyelitis, or congenital pathology (Guillain-Barré syndrome, myopathy). Usually, the appearance and development of hypotension is associated with various disorders of impulse transmission along nerve fibers.

Hypertonicity is a kind of marker of brain malfunction, which can manifest itself after head injuries, brain pathologies (generic, against the background of past diseases, including infectious ones). The most common causes are meningitis, cerebral palsy, problems with the vascular system.

Hypertonicity (muscular hypertension)

Muscular hypertension is a type of damage to muscle tissue, in which they remain in good shape for a significant period of time. The physiology of the manifestation may differ depending on the factor that provoked muscle hypertension, but in general, this occurs against the background of a malfunction of the nervous system.

The changes that occur at the same time modify the organization of oxygen supply and create additional obstacles in the supply of muscles. Lack of oxygen and poor blood supply contributes to the accumulation of biochemical waste in the soft tissues.

Causes

If in children the main cause of the development of hypertonicity is a violation of the central nervous system, then in adults this manifestation can cause stress, nervous breakdowns, physical and moral exhaustion.

There can be several reasons for muscle strain in young children:

• Parents have blood incompatibility.
• Various complications suffered during the period of gestation.
• Influence of the ecological environment.
• Birth trauma.
• genetic inheritance.

For adults, the following manifestations can become a factor that provokes the appearance of muscle hypertension:

• Consequences of past injuries (stretching, muscle ruptures).
• Overvoltage.
• Reaction to a nervous breakdown, the consequences of prolonged emotional overstrain.

Symptoms

Signs by which it is possible to determine the development of muscle hypertension (hypertonicity) in a child will help to initially engage in medical procedures:

• The child sleeps little, while he is restless.
• When the baby lies, his head is thrown back, but his arms and legs are tucked in.
• If you try to spread or spread the limbs of the baby, muscle resistance is felt, the child reacts negatively to the ongoing procedure.
• When walking, the baby does not stand on a full foot, but tries to continue moving on tiptoe.
• The child spits up more often than is normal for physiology.
• When stroking the child's neck, muscle tension is felt.
• The child often cries, while his head is in a thrown back position, and his chin trembles convulsively.

To determine the degree of muscle damage by hypertonicity, experts test the behavior of the baby.

• Having planted the child, they try to spread the baby's arms to the side.
• When holding the child upright, he tries to take a step.
• When installing the baby on the legs, he tries to hold the desired position, stretching out on his fingers.
• Conservation of symmetric and asymmetric response, in which work is observed muscle group one of the sides (turning the head, the baby compresses those limbs where the neck turns) for more than 3 months.
• Preservation of the tonic reflex (the limbs constantly remain tucked up in the prone position) for more than 3 months after the birth of the baby.

In adults, the symptoms of hypertonicity are expressed in the contraction of the muscle group of one of the parties. When moving or changing the position of the posture, there is a pain syndrome, and a fossil is felt on the affected areas of the muscles, a change in the color of the skin (blue) is visually observed. Additional symptoms of the disease are:

• Temporary stiffness in the muscles reduces motor functions.
• Permanent stiffness completely blocking the musculoskeletal system.
• Spasms.

Effects

With the pathology of hypertonicity in the areas of brain tissue responsible for the state muscular system, there are negative changes in the form of withering away. This can provoke the development of perinatal encephalopathy, the appearance of intracranial pressure and other negative reactions, which can subsequently be reflected in the form of:

• Violations of the functionality of coordination of movement.
• They become the cause of incorrect posture and form an incorrect gait.
• They inhibit the development of the musculoskeletal system.
• Slow down speech work.

Hypotension (muscle hypotension)

The weakening of muscle tone occurs against the background of a condition in which all movements are difficult. The reasons for the development of hypotension in adults and children may differ, and when diagnosing the disease, specialists are guided by the symptoms of manifestations. The manifestation of muscle hypotension at the earliest development of the disease can most seriously affect the condition of the baby in the future. Neonatal dystonia and atrophy of the musculoskeletal fibers is the factor that provokes the development of the disease.

Causal diseases

In newborns, the main causes of the development of muscle hypotension syndrome are congenital diseases. The list of genetic diseases that can affect the health of the baby in the form of hypotension includes:

• Aicardi syndrome. One of those rare manifestations when the etiology of epileptic seizures defies full explanation.
• Down Syndrome. Pathology of the genome, expressed in a change in the number of chromosomes.
• Syndrome Opitz - Caveggia. When the disease occurs, abnormal changes in the muscular system occur.
• Robinov's syndrome. Congenital changes in the skeletal and muscular system: wide bridge of the nose, large forehead, etc.
• Grizzelli Syndrome.
• Marfan syndrome. A hereditary disease in which all the tubular bones of the skylent are elongated.
• Rett syndrome. Congenital neuropsychiatric disease.

The listed diseases are only the main part of those modifications that occur due to hereditary genetics or as a result of the effects of other past diseases. Some of them debut throughout their lives:

• Leukodystrophy.
• Muscular or spinal dystrophy.
• Hypervitaminosis.
• Dystrophy.
• Myasthenia.

signs

Muscular hypotension is diagnosed by the following signs:

• Visually distinguishable signs of lethargy, which appear both in a mild form and in complete atony. When bending, passive resistance is felt, the muscular system is flabby to the touch.
• Partial or complete absence of reflexes, movements are inactive, the tendon reflex is increased. The child cannot hold the desired position of the body, does not crawl, does not try to roll over.
• Difficulties with feeding, which provoke the throwing of the stomach into the esophagus.
• Work failures respiratory system(with cerebral hypotension).

It is also possible the presence of convulsions, developmental retardation, discomfort, rhythmic and rapid movement of the feet.

Possible consequences

Although hypotension does not pose a particular danger, if the manifestation is not treated later on, it can have a number of consequences:

• Weakened quality of the speech apparatus.
• Weak (poorly developed) muscular system.
• Violation of the swallowing reflex.
• Joint problems (frequent dislocations).
• Insufficient reflex level.
• Problems with sound pronunciation.
• Chronic diseases of the respiratory tract.

At what period do children have a problem with muscle development?

Problems with the muscular system in different age periods of development of children.

• Immediately after birth. Hypotension is diagnosed using a complex of reflexes. The cause of manifestation is Negative consequences for the period of gestation.
• From 3 months to six months. The manifestation is diagnosed by secondary signs and reflexes, which become more stable by this period.
• From 3 years to 7. The reason may appear against the background of past infectious diseases that modify the work of the central nervous system.

The main directions of treatment

Any violations of the muscular system require correction and treatment, in order for the problem to normalize in the future, medicine uses three main areas of medical procedures: massage, exercise therapy, swimming. Physiotherapy is prescribed in combination with any of the other types, in especially difficult cases, experts recommend drug treatment, which includes a number of vitamins, and other medicinal substances.

Swimming and gymnastics with reduced muscle tone

Treatment of low tone involves the use of a set of exercises and swimming. For children, both types are allowed almost from birth. All classes can be conducted by parents, but they must first pass short course training, which will help to correctly apply exercise therapy. Therapeutic Physical Culture help to normalize low muscle tone.

Swimming lessons are conducted under the supervision of a specialist.

All types of exercises are performed smoothly, while it is necessary to adhere to a certain rhythm.

• Hand movement. Hands smoothly rise from the bottom up and also smoothly fall. The palms of the hands are alternately placed on the child's head, making sure that the palm is straightened at the moment of application, and at the moment of lowering it is compressed into a fist.
• Leg movements. The legs are smoothly squeezed at the knees and straightened.
• Squat. The child is helped to perform the exercise if necessary.
• Rolling from stomach to back and vice versa.

Older children and adults physical therapy classes you can use various gymnastic objects: ball, gymnastic stick, hoop.

Massage for increased muscle tone

Any types of relaxing massages for hypertonicity are prescribed only after examination by a pediatrician (for children), a neurologist, and an orthopedist, who, in addition to the format of the lesion of the muscular system (group), must find out the cause that provoked the manifestation. Massage is allowed to be performed at home, but the people who will carry out the procedure must undergo a training course.

• Massages are allowed to be used to treat increased tone from 2 months of age.
• The procedure is performed in the daytime, at normal room temperature, and the first time the massage should take no more than 5-7 minutes.
• The massage begins with light stroking of the back and limbs.
• When performing the procedure, chopping movements, tingling and the use of force during rubbing are excluded.
• For the procedure, you can use baby cream or oil.