SPMS and spasticity - related?

[jensequitur]

Was just reading in the MSQR quarterly about MS in kids - the article said that spasticity is rarely seen in children, as it comes with progressive neurological damage, and is more common in SPMS.

Well, I've been having increasing problems with spasticity - does that mean I'm moving into SPMS?  I have noticed some progression of new symptoms, but I haven't really had a real relapse.  (Just a little pseudo-flare right now which is setting off my hand, neck and leg cramping.)

[Zacksmomi]

I never thought of that.  It makes total sense though.  My spasms and weakness have been in my arms so I wouldn't notice the effect of Baclofen on the weakness as much I guess.  I will keep it in mind though.  Good to think about. Thanks

And Jen best wishes in your situation I hope you figure out what works.

D

[jensequitur]

Thanks, that's good to know!  I've been dreading it, because I don't want to get any weaker, but the spasticity's getting worse...

[shoshin]

I think the two potential side effects of baclofen that are commonly problematic are sleepiness and that the baclofen exposes underlying weakness.

(D: the baclofen doesn't cause weakness; what can happen is that if there is both weakness and spasticity or stiffness, especially in the legs, then the stiffness can be compensating for the weakness and helping someone stand up. I'm not sure it helps so much in the arms (but I don't have so much spasticity in my arms). So when the baclofen reduces the spasticity then there is nothing to compensate for the weakness that is already there and people can end up with more trouble standing or walking).

My neuro started me off on a mini-dose (1/2 pill at night) and I worked up from there. I think the idea is to try to find the lowest dose that works before you get too many side effects. Probably the only way to find out if you can take enough to help with the spasticity without the exposure of the weakness outweighing the benefit is just to try it and gradually up the dose. If it doesn't work, you'd just have to go off it. Although I think you're not supposed to go off it suddenly.

sho

[Zacksmomi]

Before my Dx I was taking Soma for 4 months with absolutely no relief in my spasms.  I had constant severe tension in my cervical spine and the muscles that attach between the neck and shoulder.  I also had frequent spasms in my left shoulder.  My PCP switched my to Baclofen and the difference has been amazing.  I did not notice any difference in my strength.  I have noticed becoming weaker as I have upped my Gabapentin alot over the last month, but I do not think the Baclofen caused the weakness.  
I hope this helps

D

[jensequitur]

I've been leery about baclofen, because of my leg and arm weakness - wouldn't it make it worse?

[shoshin]

Jen: Thanks for asking this question. And yes, that cerebellar MS article was depressing. And I'm scared, too, that if my legs give out, my arms won't be so much help.

Quix: Thank for clarifying about the spasms. I somehow never could get a grip quite on what they are, but I think it's because I'm not having them.

Shell: I am on baclofen for spasticity/stiffness so I think they must be for both. The spasticity isn't gone and I don't really feel better, but I'm definitely walking better than I did before.

sho

[jensequitur]

Thanks, everybody!

It sounds like I have spasms, spasticity, and weakness!  Oh, joy...  But it's not bad, yet.  

I've been having spasticity in the hands and legs, and last night a muscle in my hand started to spasm.  Fortunately hubby was there to squish it into submission.  In the middle of the night, my left foot started to spasm!  I was muttering to myself 'no, stop that, don't do that' and managed to wake hubby up!  He asked me if he needed to rub on it, bless him - but I said no, I think it's okay.  Last time we tried rubbing on it, it started REALLY cramping up, and then my calf cramped.  Fortunately I got it to relax, and went back to sleep.

Quix - there's a rather depressing article in MSQR about cerebellar MS.  It goes a long way toward explaining my current leg weakness.  I am concerned about losing the ability to walk, but as I told hubby, I refuse to get a chair until it's apparent that I can't get around.  I can still walk, still exercise, and get around the house with the help of doorframes and walls.  If I need to, I'll get a cane - but with my arm weakness, being in a chair would be tantamount to having my legs chopped off!  And I would really hate being pushed around...

[sllowe]

Thank you for this interp Quix.  It really is easy to get each confused.

I think I know the difference now between the two and have them both, though when I presented to the Dr. w/spasms he prescribed baclofen.

Are the anti-spasticity type meds for both?  I haven't been spasticity free, but have been quite spasm free.

Thanks,
shell

[Quixotic1]

I just remembered that your question is whether there is a relationship between SPMS and spasticity and there is.

First understand that everyone (adults) with spasticity are not necessarily in a progressive form of the disease.  However, the most common form of ultimate disability is when the legs become weaker and weaker and progressively more spastic.  This is called a spastic paraparesis.  (Para - indicating both legs like in paraplegic AND paresis - meaning weakness.)  Most people well into either SPMS or PPMS will have increasing amounts of spasticity.

Painful spasms - sudden severe contractions of the spastic muscles may occur on top of the spasticity.

I have been reading that MSQR also.

Quix

[Quixotic1]

I think there is some confusion about the difference between spasms and spasticity.

The two do not always mean the same thing.

Spasms are sudden and often severe contractions of a muscle or group of muscles.  When a muscle spasms it tightens into a painful knot that is difficult to work out.

Spasticity is an over-activity of a muscles stretch receptors, such that any attempt to lengthen that muscle is met with a paradoxical tightening.  The spasticity is always present, and the muscle may feel stiff when you try to use it.  Spasticity can vary in intensity and is often worse when the person is otherwise in pain or distress.

Spasms can frequently happen in muscles that are spastic also, but I believe they can occur without underlying spasticity also.

This difference may seem to be one and the same, so if I am not clear please ask questions.

Quix

[truelove47]

When I was orginally dx,ed.  I was dx,ed as RRms.that was in 1986.

When I was RR, I was able to function pretty normaly with day to day living and work outside the home  No one even knew I had ms
other the my family                                         I did not want to hear horror stories
I did have spasms but they were bareable.and I was much younger then

The problem is now, I have had ms for so long, I cannot remember  what normal is.
My disease progressed so slowly and gradually I adjusted to it (sounds strange)

Now I am secondary and my symtoms are always with me(They ease up from time to time)  Spasms are my biggest problem right now. Sometimes they are horrible and all I can do is sit  I can find no rhyme nor reason why my muscles act this way Thank
goodness for medications.                         Be well         Linda

[jensequitur]

Hi, Heather!

Yes, at the moment I'm on Copaxone, which seems to be working all right.

[Heather3418]

I am still relapsing/remitting and spasms have been my daily friend for over a decade.  It may be more common in SPMS, but I would have to say that it's just as common in someone that is still RRMS.

I notice that my flare-ups are few and far between and less noticeable and clear as relapses.  I would guess it's because of my age and how long I have had a diagnosis of MS.  There is a fine line, I believe, in defining SPMS when you were RR before.

I forgot Jen, are you on any of the DMD's.  Fogive me for forgetting.

All the best precious one,
Heather