Česky
In addition to increased muscle activity, spasticity is also characterized by muscle shortening and partial loss of mobility. The degree of spasticity is not always the same, some people suffer from mild muscle stiffness, others have severe, even painful conditions. If the muscle tightness does not appear immediately after a stroke or other illness, the patient is not out of the woods yet. "These difficulties usually come on with a delay of several weeks or months," points out Jana Pastuchová, MD, Deputy Chief of Neurology and Head of the Spasticity Centre at Hořovice Hospital.
Improvement thanks to physiotherapy and medication
Although it is not possible to cure spasticity, according to Jana Pastuchová, it can be fought. And often very successfully. "Treatment is long-term and requires a lot of involvement of the patient or caregiver," says the doctor. If spastic paresis is left untreated, the symptoms worsen on their own. Sometimes even joint deformities occur. "That's why it's important to start therapy early. But even in the late stages we can improve function and reduce discomfort," she explains.
Rehabilitation of spastic paresis, or paralysis, is essential. This focuses on three components: stretching the muscle, strengthening the muscle performing the movement and weakening the muscle preventing movement. The last-mentioned manifestation is addressed with a substance that is also used to smooth wrinkles, namely botulinum toxin.
The doctor has other options in reserve - he can use drugs from the benzodiazepine group or medical cannabis. For severe spasticity, it is possible to administer baclofen using a pump. The last resort is then surgical treatment.
Fighting spasticity in our hospitals
One of the places where doctors treat increased muscle tension is the Spasticity Centre of Hořovice Hospital, which is part of the neurology department. "We were granted the status of a Regional Spasticity Centre in 2022, but the examination and treatment of patients has been going on for several years in cooperation with RN Beroun," explains the deputy head of neurology.
The team that takes care of the patients includes a neurologist, a rehabilitation doctor, physiotherapists and occupational therapists trained in this field and a speech therapist. "The largest group in our facilities are stroke patients," says MUDr. Jana Pastuchová.
In Hořovice, patients are examined and educated, and botulinum toxin is administered. Another facility where investigations are carried out is the Rehabilitation Hospital Beroun. If it is a more complex case, it is possible to consult a higher workplace by agreement. "We cooperate mainly with the Comprehensive Spasticity Centre of the General University Hospital and the Department of Rehabilitation and Physical Medicine of the Central Military Hospital," the neurologist lists.
I like motivated patients and less frequent diagnoses the best, says neurologist MUDr. Jana Pastuchová
Why did you decide to go into neurology?
I was interested in the complexity and intricacy of the nervous system. Today, neurology is a very dynamic field. I am pleased that over the last few years it has moved from a predominantly diagnostic field to one where new treatment options are constantly emerging. And although we are not yet able to offer a cure for many diagnoses, it is within our power to alleviate the symptoms of disease and thereby improve quality of life.
What cases are you most excited about?
That's a tough question, the doctor doesn't choose the patients. I can say that I find it interesting to come up with a less common diagnosis. But I'm probably most pleased when I come across a motivated patient and together we can achieve improvement.
What can people do to avoid neurological problems for as long as possible?
There is probably no magic advice, but in general, what is good for the heart is good for the brain. That means regular reasonable physical activity even in old age; twenty minutes of brisk walking a day seems to me to be a maintenance minimum. A balanced diet, not smoking, significantly reducing alcohol consumption, getting enough sleep. And last but not least, take care of good relationships. Man is a social creature and without good interpersonal relationships he will wither away.
Do you suspect spasticity in yourself or a loved one? Contact one of the spasticity centres.
At the Hořovice Hospital you can make an appointment for an examination via the central reception, via e-mail botulotoxin@nemocnice-horovice.cz or by calling 311 552 020 on Mondays and Tuesdays between 10 am and 3 pm.
Appointments at the Rehabilitation Hospital Beroun can be made by calling 311 754 356.
Treatment is in most cases on an outpatient basis. It is possible to arrange for rehabilitation during a hospitalisation at the Rehabilitation Hospital Beroun, usually for 2 to 3 weeks.
