Problems muscle tone are one of the manifestations of disease nervous system. Among them, hypertension is considered the most common disease.

Muscle tone is the residual tension of the main muscle groups during their relaxation, as well as during increased physical activity. In addition, it may be part of the resistance to passive movements during voluntary relaxation of the muscles of various groups. Muscle tone can be characterized as the minimum muscle tension that persists against the background of relaxation and rest.

A change in tone can be caused by painful conditions and traumatic injuries. different levels muscular system of the body. Depending on what specific violation occurs, the tone may be increased or decreased. In clinical practice, doctors most often encounter the concept of hypertonicity - increased muscle tone. Its common features are muscle tension, their excessive density and a small range of motion. A person feels some discomfort, the amplitude of his movements decreases. He may feel better after massage or mechanical rubbing of the skin surface. Moderate hypertonicity is characterized by muscle spasms that cause acute pain. More severe situations are characterized by muscle compactions, as a result of which the reaction to mechanical influences is quite painful.

Why is muscle hypertonicity dangerous?

Muscle hypertonicity is dangerous at any age, but it is especially dangerous for children. Parents must definitely respond to its manifestations, because if you do not take action, the following consequences are possible:

• persistent violations of normal coordination of movements;
• violations of the full development of motor skills of movements;
• poor posture and heavy gait;
• frequent and severe pain in the lumbar spine;
• speech problems at all stages of development.

Also, muscle hypertonicity is very dangerous in adults at any age. It can cause the following effects:

• violations of normal coordination of movements;
• development of persistent and severe pain in the muscles and joints;
• violations of normal gait;
• heaviness in posture and movements;
• violations of the normal process of blood circulation in the muscles.

The danger of hypertonicity of muscle groups is also in the unpredictability of the time of its detection. The consequences can manifest themselves many years later in the form of the development of pathological conditions and the failure of the functioning of many vital organs and systems.

Types of increased muscle tone

Types of increased muscle tone differ in patients depending on their age and gender. Below are some of the main options for the described state.

Plastic

This is the name of a special condition of the muscles skeletal muscle, which occurs as a result of organic or functional disorders of the brain. It is part of a condition that is interpreted as catalepsy. The manifestations of this type of hypertonicity are explained by the development in the body of a condition in which the functions of formations in the subcortex of the brain are disrupted. Treatment is prescribed mainly inpatient, as a result of which the consequences of what is happening are treated and all accompanying symptoms are eliminated.

With plastic hypertonicity, there are persistent violations of the functioning of muscle groups that have undergone enslavement, as well as destruction of cells of the subcortex of the brain over time. Symptoms and external signs of stochastic spasm develop in the muscle groups exposed to the tone.

Spastic

This kind of hypertonicity is characterized by uniform involuntary contractions of muscle groups in the main areas of the lesion. It is accompanied by persistent pain in the described places, which are likely to recur later. Spasms are periodic, occurring at regular intervals, and constant, which are characterized by regularity and persistent flow. This variety of the described condition is characterized by a persistent violation of coordination of movement in the future, the development of neuralgia of the affected muscle groups and regular disorders of motor activity. Treatment in this case is symptomatic, aimed at eliminating external symptoms, depending on the type of manifestation in each specific situation. It is observed mainly in the elderly, while there are cases of its occurrence in adolescents and relatively young people.

Causes of high tone

The causes of high muscle tone are not always associated with a violation of the functioning of various organs and body systems. They can also be purely physiological:

1. Excessive load on the spinal muscles. This happens in cases where they need to work for a long period of time, due to the complete exhaustion of the energy reserve at their disposal. As a result, freezing muscle fibers in a certain position. Mobility returns with great difficulty, it requires a very large amount of energy to be expended.
2. Frequent stay in an uncomfortable position. This is a very common cause, statistically noted in about 65% of all cases. In particular, this applies to people who work a lot and for a long time at the computer. The load in such a case falls on the cervical region. Gardeners suffering from increased hypertonicity of the back muscles have similar prerequisites. Eliminated which is quite difficult.
3. The body's response to pain. Muscle spasm is very often an involuntary response to muscle pain. Spasms of the muscles of the spinal region are observed in cases where there are injuries of the chest, cervical and lumbar spinal column. The spine suffers greatly and experiences significant inconvenience.
4. Stress and constantly getting bruises.

Common diseases often lead to the occurrence of hypertonicity. Of all their diversity, the following can be noted:

• the occurrence of tumors in the patient's brain;
• strokes;
• Parkinson's disease;
• epileptic seizures;
• frequent cases of tetanus;
• multiple form of sclerosis;
• cerebral palsy;
• other possible violations of muscle and motor activity.

The list can be continued indefinitely. High tone in a patient can be noted at any age and be observed due to a variety of circumstances. A correct understanding of the causes of what is happening is the basis for the appointment of measures to eliminate such a disease.

Characteristic symptoms

The signs of the described condition are diverse and depend on the age of the patient and the nature of his state of health. Basically, the symptoms are reduced to some of the manifestations described below.

In children

Symptoms of high muscle tone in children include the following:

• the child begins to steadfastly hold the head much earlier than the due date;
• by about the third month of his life, the baby still does not know how to open his palm in order to grab and hold the thing he needs;
• the baby's head constantly tilts in the same direction;
• the child constantly trembles and twitches his chin, he often arches and his head throws back;
• in the case of hypertonicity in a child on his back, he often burps and regularly vomits.

These symptoms are not permanent and may change over time. In addition, depending on the age of the baby, as he grows up, they can be diluted with other manifestations.

In adults

Hypertonicity in adults manifests itself somewhat differently. Among its main symptoms are the following:

• severe, persistent pain in the affected parts of the back;
• violations of coordination of movements;
• a feeling of muscle congestion during prolonged stay in a certain position of the body;
• disruption of motor activity;
• difficulty staying in a certain position for a long time;
• development of problems with the musculoskeletal system;
• other symptoms characteristic of the type of disease in question.

In an adult, symptoms may change over time and depend on its general physiological state. With the development of symptoms of such a phenomenon, a deterioration in the general condition of the patient is observed.

How to remove hypertension?

Removal of the symptoms of the described kind is possible by various methods. Below is a listing of some of them.

Physiotherapy methods

Among the most common methods of physiotherapy are paraffin and electrophoresis. In particular, such techniques prove their effectiveness when applied to young children. Physiotherapy acts in this situation as one of the options for psychotherapy.

A preventive interview is conducted with the children, the basics of what is happening are explained and possible reasons fears that cause the described problems. In addition, a complex of physiotherapeutic procedures may include the practice of massage in addition to the main measures of influence.

Physical exercise and massage

Among exercise complexes of muscular-articular gymnastics and exercises to strengthen skeletal muscles are distinguished. It is recommended to perform the complex gymnastic exercises for the development of the spine. They include a series of exercises performed on the floor from a supine position. A series of consecutive twists also helps to straighten out tight muscle groups and straighten muscle fibers in various parts of the body. Special results are achieved in this matter when performing a set of exercises. traditional yoga. Among them, it is necessary to single out, first of all, asanas, built on twisting various parts of the body. This simple option is recommended. From a supine position, straighten your arms to the sides, then stretch your right foot to your left hand. If possible, do not tear off the shoulder blades from the floor. Hold for half a minute. Then return to starting position and twist in the opposite direction. Keep the same time. Regular practice of performing such exercises will be quite sufficient to maintain the effect of stable straightening of enslaved muscles.

Massage is performed primarily in the most constricted areas of the body, usually the back and lower back. Smoothing movements are made clockwise and counterclockwise sequentially. If necessary, pressure can be applied to the most stressed areas, while making sure that the patient does not experience excessive pain. Subsequently, with the gradual leveling of the situation and weakening as a result of performing these techniques of clamping in the muscles, the time for performing massage procedures should be gradually reduced.

Medications

Among the medicines recommended in such situations, sedatives stand out. Often, herbal infusions, teas with chamomile and ginseng are used to counteract emotional outbursts. This refers to the number of means of alternative, traditional medicine.

For treatment with pharmaceutical preparations, muscle relaxants and antispastic agents are used. When choosing them, first of all, the ability of drugs to perform the functions of restraining convulsive muscle contraction is taken into account. Spasticity is reduced, while there is no effect on the indicators of the strength of muscle groups and their elasticity.

Among the muscle relaxants most often used in the country: Tizanidin, Tolperisone, Baclofen, Gedozepam. It is recommended to use them only as prescribed by a doctor, self-medication in such situations is contraindicated.

Features of the treatment of hypertension in children

The main feature of therapy in young children is attentiveness to the manifestations of such a condition and the timeliness of taking measures to eliminate it. Timely prescribed treatment helps to get rid of the problematic condition quickly and without problems.

The doctor may recommend a soothing bath with pine needles, motherwort and sage are also used. All these herbs have a high-quality sedative effect and the ability to eliminate hypertonicity at any stage of its development. The course of treatment is ten days from the moment of the first application. Use is supposed to be daily, from the first to the tenth day.

A beneficial effect is the use of lavender and rose hips in the optimally selected combination for the treatment. You can also replace rose hips with eucalyptus, the overall practical results do not deteriorate from this.

Swimming is shown to all children, regardless of their age. It is able to have a positive effect on the nervous system of the baby, remove nerve impulses in the muscles and set the child in a favorable mood. It is not necessary for a toddler, from the very first days of life, to be with their parents in the pool. Enough swimming in the bath, with a special circle worn around the baby's neck. In the future, as the baby grows, you can visit the pool and swim at the time set for each age. The child is shown massages after swimming in the presence of certain problems with muscle clamps. It is recommended that you first consult with your doctor to develop treatment measures and then eliminate the described problems.

More information about the treatment of infants can be found in the article "Hypertonus in infants - Infants (children)".

Muscular hypertension can be spastic, plastic or mixed. It is provoked by physiological and pathological causes, including trauma, stroke, infections of the central nervous system, cerebral palsy.

Muscle hypertonicity is a pathological condition during which all the muscles of a person are in constant tension. In this case, the patient has an increase in the resistance of the tissues that form the muscle in the process of performing passive motor manipulations in one or more joints.

In neurology, muscle dysfunction is divided into 2 types: hypertonicity and hypotonicity (muscle hypotension). If in the first case the tone of muscle tissues is increased, and they are always in a tense state, then in the second situation everything happens exactly the opposite. However, it is hypertonicity that occurs most often among patients, so you need to know as much as possible about it.

The causes of muscle hypertonicity are divided into 2 groups:

• physiological;
• pathological.

Each of these types includes certain factors that contribute to the development of pathology. So, the physiological causes of hypertonicity imply the following:

• excessive stress on the muscles;
• overwork;
• prolonged sitting in an uncomfortable or unchanging position;
• manifestation of the body's reaction to sudden pain;
• bruises and injuries;
• strong and regular stress.

Causes of muscle hypertonicity from the category of pathological:

• previous strokes (ischemic or hemorrhagic nature);
• the presence of neoplasms in the brain or spinal cord;
• vascular pathologies of the brain;
• traumatic brain injury;
• parkinsonism syndrome (Parkinson's disease);
• epileptic seizures;
• myopathy;
• tetanus;
• infectious diseases of the central nervous system (encephalitis, meningitis and others).

Muscle hypertonicity is never asymptomatic, so recognizing it, being aware of the signs of its manifestation, will not be special work. But it is important to take into account the fact that certain symptoms of pathology depend on its type. It is on them that we need to dwell in more detail.

Types of muscle hypertonicity and their features

Muscular hypertension can be of two types:

• spastic;
• plastic.

The spastic type is characterized by a violation of the integrity of the structures of the pyramidal system, which is responsible for the performance of motor operations by different groups of skeletal muscles. In this case, we are talking about serious damage to the central neuron of the pyramidal system. At the same time, spastic hypertension of the muscles occurs in a person. For this type of pathology, a distinctive feature is that at first the movement is performed with difficulty, but after that the resistance of the muscles stops on its own, and the person can calmly complete the action. This anomaly is called the jackknife effect.

It is possible to notice such a deviation only if the movements are carried out quickly or even swiftly. Since spastic muscular hypertension affects the motor center of the brain, such an anomaly often affects not one individual muscle, but their entire groups. For example, you can notice the "jackknife" effect when you flex or extend your elbows, knees, or other parts of your body. This anomaly is quite common among patients who have had a stroke, in which there was a serious disruption in the functioning of the motor centers of the brain.

The plastic type of muscular hypertension is characterized by damage to the extrapyramidal NS, which is responsible for maintaining the body in the position taken by the person, as well as for motor reactions during crying, screaming, laughter and other emotional manifestations. This type of muscle hypertonicity is also called rigid. In this case, the tension of muscle tissues is present in the patient on an ongoing basis, and not at the beginning of certain motor operations.

Plastic muscle hypertonicity is accompanied by the so-called "wax flexibility", when a limb or other part of the body freezes in the position that the person gave it.

When performing passive movements, their discontinuity is noted. Often a similar anomaly is observed in people suffering from Parkinson's syndrome.

If damage to neurons occurred in both systems at the same time, then in this case we are talking about a mixed type of muscle hypertonicity. In patients suffering from this type of muscular hypertension, the symptoms of both spastic and plastic hypertonicity are combined.

Clinical picture of muscular hypertension

Symptoms of muscle hypertonicity are very difficult to miss, whether the patient is an adult or a small child. The characteristic clinical manifestations of the syndrome are the following signs:

• constant muscle tension;
• a significant decrease in the mobility of the part of the body where the muscles were affected;
• discomfort when performing certain motor manipulations;
• feeling of muscle stiffness;
• spasms in a single muscle or in entire muscle groups;
• committing spontaneous (uncontrolled) motor manipulations;
• a significant increase in tendon reflexes;
• severe lethargy when relaxing muscles that were subject to spasms.

In young patients, in addition to the symptoms described above, with increased muscle tone, sleep can also be severely disturbed and general well-being worsens. They lose their appetite, they become capricious and whiny.

It is possible to recognize the presence of such a pathology in a child by one pronounced sign, which is walking on toes. Such an anomaly can also be observed in an adult who developed hypertonicity in early childhood.

Having noticed such an alarming symptom, the patient must make an appointment with a neurologist and undergo the necessary diagnostic procedures. Based on the data obtained, the doctor will be able to develop the most effective treatment regimen. It is individual for each patient, so self-medication in this case is strictly contraindicated!

Treatment of muscle hypertonicity in adults and children

After all the necessary medical studies have been carried out (MRI, OAC, EMG), and the diagnosis has been confirmed, the neurologist proceeds to draw up a therapy regimen. Here, an integrated approach plays a huge role in the following areas:

• elimination of symptoms of muscle hypertonicity;
• correction of complications to which this syndrome can lead.

Unfortunately, the root cause of the development of muscle hypertension can not be eliminated in all patients. Comprehensive treatment of muscle hypertonicity implies the following aspects:

• conducting drug therapy;
• massage sessions;
• exercise therapy;
• conducting psychotherapy.

Drug treatment is aimed at stopping spasms and pain in the patient. For this purpose, muscle relaxants, metabolic drugs and antipsychotics, as well as vitamin complexes are used.

In addition to taking medications, patients are prescribed electrophoresis sessions with relaxants and anticholinergics. Such therapy is indicated for patients with spastic type of muscle hypertonicity.

Physiotherapy exercises and massage sessions help to restore the smoothness of movements, however, in order to achieve better results, it is necessary to carry out such therapy at the very beginning of the development of the pathology. These two therapeutic methods perfectly complement each other, due to which high results are achieved from their introduction into the treatment regimen.

Massage can be prescribed not only for all muscle groups, but also for individual points on the body. It is used in the event that hypertonicity is not continuous, but local. The points that will be affected are determined by the attending physician individually for each patient.

Sometimes, with muscle hypertension, surgery can be prescribed, but it is carried out only in extreme cases. severe cases. Operations are performed on the brain or spinal cord, peripheral nerves and muscles.

Psychotherapy is carried out for the complete rehabilitation of the patient after completing the course of basic therapy. Despite the fact that the treatment of muscle hypertonicity is a rather lengthy and laborious process, it still gives excellent results. The main thing is that the patient himself should be tuned in to a positive outcome of therapy, and contribute to this in every possible way. Then he will have much more chances to get rid of the pathology for a long period of time and improve the quality of his life.

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 that affect the segmental level of the 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 a transverse spinal cord lesion, 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 can be reduced in various types of cerebellar damage, chorea, akinetic epileptic seizures, deep sleep, during syncope, 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 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 of the pelvic girdle and trunk) and is accompanied by characteristic spasms of great intensity in response to external stimuli of various modalities (enhanced startle response) .

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

Tetanus is an infectious disease that is manifested by generalized muscle rigidity, although the muscles of the face and lower jaw are involved earlier than others. Against this background, muscle spasms that occur spontaneously or in response to tactile, auditory, visual and other stimuli are characteristic. 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.

The human body is a complex system consisting of functional subsystems. The skeletal system supports the weight of the body through bones and ligaments within the limits of joint mobility. The musculoskeletal system creates the transmission of forces while maintaining the weight of the body. Muscles work in interaction with each other. And any violation of the muscles leads to disruption of the body as a whole.

Muscles in tone

Muscle tone is the residual tension in the muscles during relaxation. Muscle tone is not accompanied by fatigue. This is a very important indicator that allows you to judge the degree of muscle damage. The nature of this condition has not yet been established, but experts are of the opinion that muscle tension at rest can change under the influence of external factors or diseases of the nervous system. Impaired muscle tone is one of the manifestations various diseases nervous system.

Pathology of the muscular system

hypertonicity muscle is a big problem in neuroscience. It is accompanied by pain and movement restrictions. The main signs of increased muscle tone are:

- voltage

- immobility

- discomfort when moving

- muscle stiffness

- muscle spasms

- spontaneous movement

- increased tendon reflexes

- delayed relaxation of spasmodic muscles

Very often, hypertonicity is accompanied by pain in the back and legs, especially during movement.

What leads to increased muscle tone? The most common causes of hypertension are:

- diseases of the central nervous system (CNS)

- multiple sclerosis

- spinal cord or brain injury

- stroke

Muscle tone is subject to mental and emotional states, temperature changes, but to the least extent.

Treatment of hypertonicity, as a rule, takes place in a complex of physiotherapy with muscle relaxants.

Decreased muscle tone

Muscle hypotonicity, on the other hand, is a state of reduced muscle tone, often combined with decreased muscle strength. Recognizing this lesion is not difficult, difficult, and sometimes impossible, to identify the cause of this condition. Diagnosis of muscle hypotonia occurs, as a rule, even in childhood.

The course of reduced muscle tone has pronounced symptoms:

- there is a sharp weakness in the muscles

- gradual development of an atonic state of the skeletal muscles

- reduced or completely absent any movements of the limbs and body

- decrease or absence of unconditioned reflexes

- difficulty in breathing

- it becomes impossible for a person to sit in the usual postures

- the joints of the upper and lower extremities become more loose and may begin to bend

The most common causes of hypotension are genetic diseases such as Down's syndrome, Aicardi's syndrome, Robinov's syndrome, Patau's syndrome, Williams' syndrome, etc.

In addition, the diseases that a person has had throughout his life also play an important role. These include:

- development of dystrophy of various muscle groups

- atrophy of the spinal muscles

- transferred encephalitis, meningitis

– poliomyelitis

- sepsis

- myasthenia gravis

- hernia of the esophagus

Muscular hypotension is usually a consequence of the disease. That is why drug therapy is aimed at eliminating the disease that led to the disruption of the body's muscular system. The main goal of treating muscle hypotonia is the gradual reduction and elimination of the symptoms that appear: weakness in the muscles, difficulty breathing, inability to perform certain actions and movements.

It is very important that the course of treatment for each patient is strictly individual. And independent changes in the prescribed treatment is not acceptable.

Massage and exercise for muscle tone

There are several simple exercises, which will help relieve tension in muscles and ligaments, and help the body relax:

- leaning to the side

- flexion of the body

- hamstring stretch

In addition to basic exercises, self-massage can help with muscle tone disorders. The patient must take comfortable posture, with the help of fingertips, the neck is rubbed. Then the back of the neck is stroked. In this case, the palms are pressed quite tightly to the neck. The muscles of the shoulder girdle are kneaded with pinches. At the end of the massage, the neck is tapped with the fingertips, and slow circular strokes are performed.

Violation of muscle tone in children

In children under one year, muscle tone disorders are not uncommon. After all, a child who has lived in his mother's tummy for 9 months in the fetal position is characterized by muscle tension. This can be caused by both congenital pathologies and factors surrounding the child. It is important to identify the problem and its cause in time in order to prescribe timely and effective treatment in order to avoid such consequences as deformation of the joints and skeleton, movement disorders.

In a child of the first year of life with hypertonicity, stiffness and stiffness of movements are manifested. The baby can not relax even during sleep. Hence the accompanying problems - anxiety, sleep disturbance, chin trembling.

The causes of such a violation may be birth trauma or birth hypoxia.

Hypotension in children under one year in its manifestation is less common than hypertonicity. Most often, such violations affect babies born prematurely, as well as children with infectious diseases and endocrine system disorders. Such a violation is manifested, as a rule, by rare whims. These babies rarely cry.

The cause of reduced muscle tone can be a serious birth injury, such as an intracranial hematoma. As a result, the child begins to lag behind in psychomotor development, starts holding his head late, and gains weight poorly. And most importantly, such a violation can lead to respiratory disorders.

Complex therapy prescribed by specialists for violations of muscle tone includes:

– physiotherapy – mud therapy, electrophoresis

– course massage to relax “tired” muscles

Muscle tone is the involuntary tension of our muscles. This process is permanent. Our consciousness and will do not control it.

Have you ever wondered how muscles tense up? What controls them? If the muscle tone is in a normal state, then we do not notice it. This is our usual state, which does not cause any discomfort. Despite the fact that we do not attach importance to this, the tone exists.

This is an important characteristic of our muscular system. It affects the state of all organs and systems. Without it, we will not be able to move normally, walk and even stand.

An important function of the skeletal muscles is to maintain their working condition. They must be in full readiness at any time, whether we are asleep or awake. And reflexively, the tone of the muscular system helps us maintain a certain position of our body.

What is the norm and what is the deviation

What is the difference between tonic muscle tension and normal? If the tension is arbitrary, then a number of muscle fibers are simultaneously activated.

Imagine that each fiber is a light bulb. During voluntary tension, the entire muscle will look like a bright fiery beam. But in the case of tonic tension, it will already resemble a sky strewn with stars. Notice the difference?

In the second case, the fibers will not all enter into work at once, but in turn: some tense up, while others rest. Thanks to this economy, the fibers can work for a very long time. In the distribution of tonic tension, the sensitivity of muscles and joints plays a decisive role.

Studies have shown that muscle tone can vary greatly from person to person. Even for one person at different points in his life, this indicator will change. For example, when we sleep, the tone is lowered. During mental or physical work, it will increase, and during rest and rest it will decrease again. With a reduced tone, efficiency is lost, but a high tone will interfere with productive work.

It is curious that muscle tone can affect the state of the human psyche. As it turned out, when the tone changes, our emotions also undergo changes. Reducing it can calm a person and even put him to sleep. But mentally controlling this indicator is quite difficult.

Hypertonicity - about causes and consequences

If the muscles are in a pathologically high tone, the following signs can signal this:

• their density increased;
• does not leave the feeling of tension;
• you feel tight;
• movements are constrained;
• you feel muscle fatigue;
• the rate of muscle growth slowed down;
• often there are muscle spasms with acute pain.

There are two types of hypertension:

1. . On different muscle groups, the tone is disturbed in different ways.
2. Muscle rigidity. The tone is equally high in all muscle groups.

Why does hypertonicity appear

Most often, this pathology is associated with a violation of the nervous system. It is from her that signals come, after which the muscles relax or tighten. It is she who controls their tone. Increased muscle tone can appear for various reasons:

• cardiovascular diseases (they damage the central nervous system);
• neurological pathology congenital;
• due to injury, the brain or spinal cord was damaged;
• a person has demyelinating diseases.

And the tone may depend on the psychological state. Our central nervous system often perceives all sorts of shocks and stresses as a potential threat, and sets in motion muscle tone. Slightly affect the tone and weather conditions. In warm weather, the muscles are relaxed, and the cold provokes their tension.

Types of muscle tone disorders

Muscle tone disorders:

Muscle tone is observed in most newborns. At first, this is normal phenomenon. It is due to the fact that the baby after the fetal position must get used to the new position of the body. Do not be afraid if your baby has been diagnosed with muscular dystonia.

Tone is an important characteristic of the state of the nervous system of the child and his general condition. Violations of it can be a symptom of serious pathologies of the central nervous system, spinal cord and brain. For example, dystonia always accompanies elevated intracranial pressure.

Violations of tone can provoke delays in physical and mental development. Such babies later begin to crawl, sit, walk.

Therefore, it is worth showing the baby to a neurologist. Babies born are considered a special risk group. ahead of time, "caesareans", children with low weight.

The consequences of violations of tone for children can be different:

• posture, gait may deteriorate, sometimes clubfoot appears;
• hypertonicity can later turn into hyperexcitability, the child will be inattentive, study poorly, and begin to show aggression;
• hypotension leads to physical and psychological lethargy, apathy, hypodynamia, obesity, developmental delay.

It is important that parents monitor the condition of the child. For the first months, it is normal for the baby to stay in the fetal position. The newborn may experience increased muscle tension. For them, the physiological tone is normal. That is why even a newborn should not be left unattended on the changing table. He can actively move his legs, arms and even roll over.

Parents should be concerned if:

• the hips of the newborn are divorced more than 90 degrees, this is a symptom;
• spreading the hips of the child, you feel excessive resistance, this is a symptom of hypertonicity;
• a symptom of a violation of tone is an unnatural posture of the child in the crib. In pathology, it can shrink into a ball or, conversely, spread out like a frog;
• the child does not eat well, cries for no reason, throwing his head back;
• convulsions and fever are observed;
• the baby does not gurgle, does not smile.

You can not swaddle the baby tightly, even at night. With such swaddling, the child is in a very unnatural position. Doctors have noticed that babies who are not swaddled tightly are less likely to have impaired tone and neurological problems.

If, nevertheless, a correction of the tone is required, then most often it is prescribed massotherapy. It is prescribed to babies after a month and a half age.

Medical therapy is rarely used. The specific treatment will depend on the underlying causes. Do not be afraid of massage.

The main thing is that it should be performed by an experienced and qualified children's masseur. A good professional massage normalizes muscle tone, improves blood circulation, and stabilizes the nervous system.

It is useful for a child to do simple exercises:

1. Stroke his back, the legs of the handle. At the same time, it is impossible to affect the lumbar region.
2. Massage your palms, heels, fingers on legs and arms. Movements should not be strong and abrupt.
3. After three months baby can do more difficult exercises. They can be selected by a physiotherapy specialist.

To correct muscle tone, baths with herbs (soothing collection, motherwort, chamomile), sea salt will be useful.

Diagnostic tests

Special diagnostic tests will help determine the state of tone. The first examination of the baby is carried out in the hospital. Then, every six months, parents should show the baby to an orthopedist, a neurologist. Some manipulations for such a diagnosis can be performed by the parents themselves:

1. We part the hips. The baby lies on his back. You part his hips without any effort. The norm is moderate resistance. With a reduced tone, it is completely absent, and with an increased tone, it is too strong. A healthy baby should spread the legs 45 degrees on each side.
2. We sit the baby by the arms. The baby lies on its back. Pull the baby by the wrists as if you want to sit him down. The norm is a slight resistance to extension in the elbows of the hands. With a reduced tone, there will be no resistance, with an increased tone, it is excessive.
3. Step reflex and ground reflex. Holding under the armpits, place the baby on the changing table. To encourage you to take a step, lean forward slightly. Norma - the child stands and leans on the entire foot, his toes are straightened. While leaning forward, the baby should not cross the legs, imitates the process of walking. But after 1.5 months, this reflex fades. But with hypertonicity, it lasts longer. Symptoms of hypertonicity: pursed fingers, crossed legs. Symptoms of muscle hypotonia in infants: steps on excessively bent legs (you must hold the baby under the armpits), squatting or refusing to walk.

Therapy Methods

As already mentioned, in case of violations of tone, professional therapeutic massage is often prescribed, less often - drug therapy. Most often, a neurologist prescribes a course of relaxing massage (10 professional sessions, which are repeated again after six months).

Also applies:

• special medical gymnastics;
• electrophoresis;
• swimming;
• relaxing baths with herbs (sage, valerian, motherwort, chamomile, soothing collection, needles) or sea salt;
• in more complex cases, drugs are prescribed (vascular drugs, nootropics, diuretics).

Important: Recently, pediatricians have agreed that jumpers and walkers can harm muscular system child and the entire musculoskeletal system. In them, the force of gravity is unevenly distributed. This leads to an excessive load on the spine and pelvis, muscle tension, the child gets used to not standing completely on the foot.

Remember that as you reach middle age, muscle tone may drop. It won't be too much to do therapeutic gymnastics or moderate loads gym. Remember that muscle tone directly depends general state your body, performance and emotional state!