![]() In this review, we have discussed the controversies regarding the definition of muscle tone and its classification, followed by the mechanisms and pathways responsible for maintaining tone. This hierarchy of motor control includes cortex (extensive processing capability with highest degree of freedom), basal ganglia (learning and teaching of context dependent tasks with less degrees of freedom), cerebellum (fine-tuning), brainstem reticular system (common pathway for ascending and descending tracts), spinal cord (the main pathway for ascending and descending tracts), and muscle spindle (final common pathway with least degree of freedom). Tone is basically a construct of motor control, upon which power is intrinsically balanced. It is regulated by its input and output systems and has critical interplay with power and task performance requirements. Am J Phys Med Rehabil 2004 83(Suppl):S10-18.Muscle tone is a complex and dynamic state, resulting from hierarchical and reciprocal anatomical connectivity. Yablon SA, et al: Neurophysiologic evaluation of spastic hypertonia: Implications for management of the patient with the intrathecal baclofen pump. ![]() Arch Phys Med Rehabil 2005 86: 1127-33 (found that ITB bolus injection reduces spasticity but does not necessarily improve the patient's ability to walk) Horn TS, et.al: Effect of intrathecal baclofen bolus injection on gait in persons with lower extremity spastic hypertonia due to acquired brain injury: temporo-spatial outcomes.Pediatric neurology, 39(5), 301-306 (baclofen decreases spasticity but also reduced excitability of neural structures underlying voluntary motor tasks) Classification and structural-functional correlates. al: Consensus panel recommendations for the use of intrathecal baclofen therapy in post-stroke spastic hypertonia. Developmental Medicine & Child Neurology, 57(7), 600-610. Neonatal hypertonia-a diagnostic challenge. Elsevier (diagnosing hypotonia early to identify the need for early intervention). Neonatal hypotonia and neuromuscular conditions. Physical Medicine and Rehabilitation Clinics, 31(1), 57-68 (a look at pharmacologic therapies in the treatment of hypertonia) Medical Updates in Management of Hypertonia. But the underlying conditions are usually permanent. Hypotonia may be able to improve with pharmacologics and therapy. The treatment and prognosis of the condition will be unique to each person depending on the underlying cause and how it impacts their life. Unfortunately, damage to the brain early in life can be extremely hard or impossible to correct, which is why both conditions are known for being permanent. Hypotonia, however, may be able to be prevented through early diagnosing and treating underlying conditions, unless it developed from brain injury. (This condition is sometimes misdiagnosed with Sandifer syndrome which also has dystonic movements.)Ĭurrently, there is no way to prevent hypertonia from occurring, especially if it was caused by a birth injury. Dystonic hypertonia is commonly associated with Parkinson's Disease. ![]() A person with dystonic hypertonia can have an involuntary posture due to their inability to stretch the muscles.
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