How to get rid of spasticity after a stroke? Spasticity after a stroke - increased muscle tone. How to overcome spasticity after a stroke.

For the treatment of spasticity, this is a hindrance and harm. When relieving spasticity, you need a relaxing massage and light movements in the exercises. To continue recovery after a stroke, it is necessary to carry out mutually exclusive activities. But we came up with a simple solution. Make two groups of classes.

First: to restore strength and endurance. Second to treat spasticity, restore balance and coordination. The decision turned out to be very correct. True, we did not figure it out right away and for some time we did exercises to relieve spasticity along with exercises for strength and endurance. We noticed in time that active exercises made the spasticity worse.

What is spasticity?

Spasticity manifests itself in stiffness. It is impossible to make a fast or sudden movement. Constantly tense muscles block freedom. Feeling like you are a very rusty Terminator))).
Tension leads to rapid fatigue.

Recovery from a stroke can actually be blocked by spasticity. It is difficult to restore skills when the limbs seem to be tied with rubber bands and are always in a tense, unnatural position. To relieve spasticity after a stroke, we use basic exercises. The main thing is to do them easily, without stress.

Muscle spasticity is an involuntary contraction, cramp or spasm due to disruption of the conduction of nerve impulses after a spinal cord or brain injury.

Most often this condition manifests itself at night, but it can also significantly complicate life during the day.

Mechanism of spasticity formation

Experts call the main reason for the formation of seizures an imbalance of the inhibitory effect of the motor elements of the cerebral cortex on cells in the structure of the spinal cord.

The natural result is the disinhibition of the tonic reflex - muscle spasticity is formed in the injured limbs of a person.

In a normal state, a person does not have to think about the order of the phenomena produced in the muscles: which of them first needs to be contracted, then relaxed - our brain has brought such activity to automatism.

After a stroke or injury, the death of cellular elements responsible for special inhibitory impulses in the motor neurons of the brain and spinal cord occurs. Reflex arc: limb - spinal cord - brain ceases to be a single system - coordination is impaired.

Spasms do not form immediately - for weeks, and even months. Leads to significant secondary changes in muscles and joints - enhances the negative impact of paresis on the motor system.

Degree of severity of limb spasticity

The first signs of the onset of muscle spasticity are observed on the very first day after the injury, and subsequently tend to intensify.

The degree of severity may change under the unfavorable influence of negative factors, for example:

when there is a change in emotional mood - a person has a tendency to depression;
when weather conditions change - fluctuations in temperature or light parameters;
in case of excessive physical overload caused by early physical activity of the victim, contrary to the doctor’s recommendations.

When the intensity of the load on the muscle fibers in the limbs increases, their motor activity becomes difficult, and symptoms of pain in them of varying degrees of severity are observed.

Depending on the severity of spasticity, the following forms are distinguished:

Spasticity of the legs in a mild form is manifested by rapid fatigue of the muscles of the legs, a feeling of “muscle congestion” from physical activity, walking becomes easier in heels, then it becomes difficult to pull the toes towards you and straighten it at the knee.

In a severe form of spasm, one or both legs are locked in a flexed knee or hip position and the foot turns inward or outward. When walking without special shoes or shoes, deformities or contractures may occur.

Mild spasticity of the arms: extension is difficult
fingers and straightening of the arm at the elbow joint; a sign of a severe form is bending at the elbow and shoulder joints, while the hand is clenched into a fist.

If spasticity is present for a long time without treatment, contracture develops, that is, the joint is not fixed in a physiological state for the body.

In the future, the spasm will only have a negative impact on the implementation of recovery measures. In addition to the limbs, recovery will also worsen in the spine: increased muscle tone causes pain in the back - symptoms of vertebrogenic radiculitis.

Experts note: than before adequate treatment with modern drugs was started, and also, the less severe the spasticity, the better the prognosis for rehabilitation measures.

Even if the symptoms are significantly pronounced, and treatment of seizures for certain reasons began at a later time period - reduction in spasticity significantly improves general well-being.

How to treat spasticity using different methods

The most important requirement for treatment is that it be as painless as possible, since pain is greatly amplified by spasticity.

An important point is monitoring the activity of the pelvic organs - preventing inflammatory manifestations in them, as well as timely implementation of measures to prevent the occurrence of contractures and.

A complex of modern treatment to get rid of spasticity:

medicinal tactics (mydocalm, baclofen);
techniques;
orthotics;
surgical correction.

The treatment package is selected only individually, directly depending on the location of the lesion and the severity of spasticity. It is also necessary to take into account the technical capabilities of the medical institution.

Spasticity after a stroke or brain injury necessarily requires medication. Treatment should be carried out in stages - with a gradual increase in the therapeutic dose of medication, possibly replacing the drug.

Today, two subgroups are in demand:

Drugs with a central mechanism of action on the negative focus are reflex inhibition.
Peripheral drugs – significantly reduce the stretch reflex at the level of the spinal cord elements: muscle relaxants.

Like other subgroups of even the most modern drugs, the above have their own contraindications, so only a highly qualified neurologist should prescribe them.

Orthotics and plaster

Treatment of spasticity by long-term placement of a person’s limbs in a position where the muscles are optimally stretched and tonic reflex activity is reduced is called orthosis by specialists. It helps reduce hypertension in the extremities - pathological symptoms can be reduced many times over.

In case of severe spasticity, it is even recommended to apply a special plaster splint or splint to prevent the development of contracture. It is the splint that fixes the limb in the most acceptable position - in which the muscle fibers are located in a stretched position.

Orthosis treatment is carried out from one to two hours, directly depending on the person’s sensations - if pain increases, the procedure is completed.

Physiotherapy for muscle stiffness

local use of cold - helps to reduce excessive reflexes and maximize range of motion, improve muscle activity;
local use of heat is excellent for temporarily reducing tone. carried out using ozokerite or paraffin applications, the course is at least twenty procedures;
nerve endings is an excellent technique that allows you to achieve maximum response in the affected areas; the duration of the treatment course is prescribed by a specialist.

Exercise therapy development

Treatment with exercises aimed at optimal relaxation of muscle fibers is a long-proven rehabilitation method for treating spasticity that has proven itself to be excellent.

Dosed therapeutic stretching allows you to reduce their tone for a couple of hours, maximizing the range of movements in the affected limbs.

The kinesiotherapist knows that a decrease in tone will only be observed for a certain time and therefore it must be effectively used to carry out other complex exercises that were difficult due to spasticity.

Surgical intervention is determined by a specialist according to strictly individual indications, when conservative methods have already exhausted themselves, and no pronounced positive dynamics are observed.

Relieving spasticity is an important task. It greatly interferes with everyday life, takes away strength and hinders movement. This makes it difficult to restore lost skills and stamina. To fully carry out recovery after a stroke, it is necessary to cure spasticity. We do this in parallel with other tasks.

With an integrated approach and the beginning of therapeutic measures at the earliest possible stage, drug treatment - normalization of muscle tone helps to maximize the acceleration of the patient’s recovery.

Methods such as myostimulation, Botox, of course, therapeutic exercises, medications (mydocalm, baclofen) and gentle surgery have shown themselves to work well in treatment.

What is it, causes of spasticity, prevention and treatment updated: November 21, 2017 by: author

According to WHO statistics, strokes currently occupy 3rd place (after pathologies of the heart and blood vessels and cancer) among the causes of death (among the adult population of the planet).

Patients who have suffered a stroke have a high likelihood of long-term disability, and during the first year there remains a high risk of recurrence of cerebral circulatory disorders (more than 8% of cases).

Acute cerebrovascular diseases with foci in the brain and spinal cord are often accompanied by the development of neurological and mental defects: paresis, paralysis, coordination disorders and the occurrence of convulsive seizures.

Most often, seizures occur in patients with a stroke focus in the frontal lobe of the brain and with subarachnoid hemorrhagic strokes (accumulation of blood in the cavity between the soft and arachnoid membranes of the brain).

A seizure may develop:

during an acute circulatory disorder in the brain, with seizures being one of the symptoms of a stroke;
during the period of exacerbation of the disease (several months after the stroke).

The appearance of repeated seizures after a stroke does not mean incorrect treatment - it may be a symptom of a recurrent stroke, indicate a large area of necrosis involving neurons in the motor zone, or the formation of a cyst (fluid-filled cavity) in place of the necrosis zone, which irritates the motor area of the brain .

Frequent, prolonged or poorly controlled seizures in the acute period of the disease indicate a high risk of death and are considered a sign of significant primary damage to brain tissue or progression of pathology, especially in hemorrhagic strokes.
Epileptic seizures in a patient after a stroke are considered:

as the probability of developing a second stroke;
the presence of a cyst or other neoplasms formed in the necrosis zone;
the occurrence of infectious-inflammatory or neurodegenerative processes in patients after a stroke.

In any case, when seizures occur, a complete examination of the patient in a hospital setting and determination of the cause of the development of seizures is necessary.

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Causes of seizures after stroke

The main cause of seizures after an ischemic or hemorrhagic stroke is the death of brain neurons. In the acute period of the disease and the formation of a zone of necrosis, the body tries to limit it, restore normal blood circulation in the tissues and preserve the maximum possible number of neurons and their connections with other nerve cells, so the body looks for the possibility of redistributing the functions of dead neurons between other brain cells. As a result of these self-defense mechanisms, a cavity filled with liquid is formed at the site of necrosis. In most cases, this formation does not interfere with the person, but in some cases, periodic irritation of neurons occurs, which manifests itself in the form of local convulsions or generalized seizures.

Experts believe that the main cause of convulsive attacks after a stroke is the location of foci of necrosis and the formation of post-stroke foci in the form of cysts, adhesions or other pathological formations in the lobe of the brain responsible for movement (overstimulation of motor neurons in the area of convulsions).

Predisposing factors for the occurrence of seizures after a stroke are:

nervous tension and stress;
physical or psycho-emotional fatigue;
adverse reactions after taking certain medications and others.

Signs of seizures after a stroke

Cramps are paroxysmal involuntary contractions of a muscle or group of muscles, their twitching, lasting from several seconds to several tens of minutes.

Cramps after a stroke most often take the form of short-term attacks of muscle contraction throughout the body (generalized cramps), or their local occurrence - cramps of the legs, arms, neck muscles, and face. After the cessation of a generalized convulsive seizure, blackout or sleep often occurs due to the shock state of the brain.

The clinical picture of seizures after a stroke varies: from mild neurological tremor, single contractions of certain muscle groups (tics) to severe clonic-tonic generalized seizures.

The most common manifestations of seizures in patients after strokes are:

in the form of clonic contractions of the facial muscles or short-term tonic spasms of certain muscles of the face and neck (“mask-like face”, throwing back or turning the head to one side, distortion of the face on one side);
tonic prolonged contractions of the muscles of the limbs in the form of sudden numbness and/or complete loss of motor control (the “wooden leg or arm” syndrome or legs and arms on one side of the body);
generalized epileptic seizures in the form of various episodes of seizures - tonic or clonic seizures or their combination - clonic-tonic seizure.

Leg cramps after stroke

In the legs after a stroke, the following are most often observed:

local convulsive contraction of the muscular system of the foot or calf muscles or short-term but painful tonic spasms in the calf muscles and/or toes or foot (cramps).
pronounced and fairly prolonged tonic leg cramps in the form of numbness or persistent impairment of movement (“wooden leg”)

These pathological signs are always associated with serious damage to the brain or its motor centers of the cerebral cortex.

It is important to know that seizures almost always occur on the side opposite to the lesion in the brain.

Seizures after stroke: treatment

If any symptoms of convulsive readiness appear in patients after a stroke, it is necessary to conduct an EEG of the brain, CT or MRI (as necessary) to determine the source of irritation. To eliminate convulsive readiness, a course of anticonvulsants (finlepsin or carbamazepine) is prescribed.

Traditional medicine offers several treatment methods:

use of alcohol infusion of linden (flowers) - 1 teaspoon before meals;
collection of herbs including spring Adonis, thyme and cinquefoil or decoctions of these herbs separately;
garlic, crushed and infused in unrefined vegetable oil - 1 teaspoon inside 3 times a day.

It is important to remember that when using any non-traditional methods of treatment, you cannot stop the course of anticonvulsants on your own.

Emergency care for seizures after a stroke

If convulsions occur, the patient should not be left alone: during this period, the patient may at any time need emergency assistance:

1) you need to calm the patient down, open the windows to provide oxygen access to the brain cells, remove restrictive clothing;

2) when seizures occur:

place a pillow or soft cushion under the patient’s head;
to prevent biting the tongue between the teeth, it is necessary to carefully insert a dense cloth;
if the patient has eaten something before, remove food debris or dentures from the oral cavity;
remove objects that the patient may hit his head on;
if hoarse breathing appears, turn the patient on his side and make sure that all objects obstructing breathing (belt, tie) are missing,
if muscle pain occurs, rub a limb, neck, face, or warm up spasming muscles by mixing olive oil with mustard (1:1) and apply the paste to the site of the cramp;
You can give the patient aspirin to improve blood circulation in the vessels.

Be sure to call a doctor or an ambulance, even if a seizure is quickly relieved.

What are the causes of post-stroke seizures?

Convulsions after a stroke develop in both ischemic and hemorrhagic strokes. The reasons for such consequences are the death of the structural and functional units of the nervous tissue of the brain. As a result of circulatory disorders, necrotic foci appear in one of the departments, during this period the protective properties of the body are activated, preventing the subsequent progression of pathological processes and aimed at restoring normal blood circulation.

A necrotic area of the brain after a stroke leads to irritation of neurons, which subsequently cause seizures.

These protective processes in the body lead to the formation of cavities filled with liquid in necrotic areas. This condition does not cause pain or discomfort, but provokes irritation of neurons, resulting in seizures.

There are other reasons:

cyst in the frontal lobe of the brain: an attack is a harbinger of a recurrent stroke;
infectious processes: infection can occur during surgery or in the postoperative period, resulting in a convulsive state;
other reasons: stressful and depressive situations, physical fatigue, use of medications.

Seizures after a stroke are an extremely dangerous condition that can be a harbinger of a recurrent stroke or cerebral infarction.

Clinical picture

Depending on the cause, the severity of symptoms differs in each patient: in some patients it is a slight tremor of the upper and lower extremities, in others it is severe epileptic seizures.

Timely recognition of signs of the onset of a convulsive state can save a person’s life. Symptomatic complex:

the person stops responding to people around him and does not answer questions;
dizziness may occur;
some patients experience convulsive fainting;
tension in the muscles of the upper and lower extremities appears;
then the increased muscle tone turns into convulsive twitching;
with severe convulsions throughout the body, the person bites his tongue;
Spontaneous urination is possible.

As a rule, an epileptic seizure lasts no more than a few minutes. After which the patient loses consciousness, this state is similar to a prolonged sleep.

Types of seizures

An attack after an acute stroke develops according to one of the following types:

clonic: spasms appear in the legs and arms, in one half of the body, or involve a specific muscle group; a convulsive attack is replaced by short periods of relaxation;
tonic: intense muscle tension, characterized by a long duration; Leg cramps are more common, but muscle spasms in other parts of the body may also occur.

First aid for seizures after a stroke

In case of a convulsive state in a patient who has suffered a stroke, it is necessary:

call an emergency medical team;
if a person experiences fainting with convulsions, it is necessary to ensure that he is in a supine position;
provide fresh air access to the room, if possible, free the patient from tight clothing;
the head should be in an elevated position, and it must be ensured that there are no sharp or heavy objects that could injure the patient during loss of consciousness with convulsions;
check for the presence of food debris, saliva or vomit in the oral cavity, and then remove them; if there are removable dentures, they are removed;
if the attack is accompanied by wheezing, the patient must be turned on his side and the respiratory function must be monitored;
in case of convulsions with prolonged seizures, it is necessary to restrain the person at all times to prevent injury;
if the condition is accompanied by severe muscle spasms, while consciousness is preserved, you can rub the muscles or apply a compress of mustard and olive oil.

The main treatment is prescribed only by a neurologist after the causes have been established.

Treatment regimen for seizures

To eliminate the underlying cause, diagnostic measures are carried out, consisting of CT, MRI, examination of cerebral vessels, general blood and urine tests. After receiving the results, the doctor prescribes the most effective treatment, individually in each case. For true epilepsy, therapy consists of a more extensive range of medications.

The main drug in the treatment of seizures is Finlepsin (Carbamazepine).

The following drug treatment is also used to eliminate seizures:

antithrombosis drugs: for cramps in the legs and arms, drugs that reduce blood clotting are used, which improve blood flow through the vessels; one of the easiest drugs is aspirin;
drugs to improve blood circulation and oxygen saturation of affected areas of the brain;
neurometabolic stimulants (nootropics) – improve brain activity.

Treatment is carried out according to the regimen prescribed by the doctor; in each individual case, the dosage and duration of administration differ. You can predict an attack and determine the effectiveness of the therapy using an encephalogram.

The main drug in the treatment of seizures is Finlepsin.

As a rule, a few days after taking the medicine, leg and arm cramps disappear, and muscle sensitivity returns. Fainting and dizziness also disappear, and clarity of mind returns.

With adequate and timely treatment, the chances of getting rid of seizures and preventing the development of a recurrent stroke increase.

What complications can occur with seizures after a stroke?

A convulsive state is an extremely dangerous consequence of a stroke, and without treatment it can lead to serious complications. Deterioration of the condition is possible with convulsions with loss of consciousness during stroke.

In case of a convulsive state, the following consequences occur:

recurrent stroke – poses a threat to the patient’s life;
coma – there are convulsions after a stroke that provoke long-term or short-term loss of consciousness; with more intense and severe attacks, a person may fall into a coma;
disability - constant seizures that are difficult to treat indicate serious disorders in the brain, which leads to disability without the possibility of recovery;
death of the patient - if convulsions occur frequently and therapy does not produce positive results, it can be assumed that there is internal bleeding that cannot be treated and death occurs as a result.

To eliminate the symptoms of this condition and prevent possible serious life-threatening complications, you must consult a doctor promptly. Only emergency medical workers can stop an attack, so you should not decide on your own to take any medications.

Leg cramps: causes, treatment, symptoms.

To know how to deal with something, we must always know the reasons for its occurrence. The occurrence is no exception leg cramps, causes which we will consider in this article. We will also provide some of the best and most current advice on treatment with folk remedies and traditional medicine. As for leg cramps, they can be caused by all sorts of external and internal irritants, and their essence can be extremely different. In cases where these conditions occur not only in the legs, but also in other parts of the body, the causes must be looked at in each case individually.

At its core, these are involuntary and independent of the diseased contractions of the so-called striated muscles, which are also commonly called skeletal muscles. Such conditions, as many people know, have the nature of attacks, which at any period of time can differ greatly from each other. Namely, they can be episodic or regular.

Convulsions can also be clonic (short-term muscle contractions, as well as their relaxation) and tonic (here we are talking about a duration of up to three or even more minutes). It is also customary to distinguish the following types of attacks, namely, when almost all the muscles of the body contract, these are generalized; when only a certain group of muscles contracts, these are localized.

Tonic leg cramps are caused, first of all, by a violation of the composition of human blood, both biochemical and electrolyte. This happens when the body loses a large amount of salts, when the concentration of calcium, magnesium or potassium itself decreases. It may also be due to an insufficient amount of vitamin D in the body. Other causes of leg cramps include sunstroke or heatstroke, and as a result, increased body temperature. These conditions often appear in those people who simply overstrained their muscles (after prolonged or sudden physical activity or exercise, as well as cramps of musicians or typists in those parts of the body that are most involved in their work).

It is worth noting such causes of cramps not only, by the way, of the legs, as the emergence of a kind of focus of irritation in the motor part of the brain. As a rule, this is noticed when a person begins to have a stroke, or during the rehabilitation period after it. Infectious infections of the nervous system can also be added here.

Let us list some other reasons: alcohol intoxication, lack of blood sugar, or, conversely, an overdose of sugar-lowering substances in people with diabetes, innervation of the spine in patients with osteochondrosis. It is worth noting that seizures are a common occurrence in absolutely healthy people. And in these cases they can be explained by the body’s reaction to some very strong stimuli.

Everyone will probably be wondering what to do if you suddenly have a cramp, what are the initial and necessary measures that you can immediately take. Firstly, you need to stand on the cold floor and try to walk or just walk a little, secondly, rub these muscles thoroughly and with strong energetic movements of your hands, thirdly, lie down and stretch your leg so that your toe can be pull the opposite way towards yourself, fourthly, you need to take a couple of teaspoons of mustard, one teaspoon of olive oil. Lubricate all this slurry exactly the place that is located above the muscles that are spasming. It is best to also take some kind of painkiller, aspirin, for example, because in addition to the analgesic effect, it will improve blood microcirculation in the vessels. Keep in mind that you need to take it in cases where you have no contraindications for this, namely the risk of bleeding.

Now, speaking about leg cramps and the causes of their occurrence, let’s move directly to medicinal plants and folk recipes.

1. You can use a plant such as Adonis vernalis. Take a couple of teaspoons of pre-chopped herb per glass of boiling water. You need to use this remedy: adults – a tablespoon three times a day; children - 2 years of age - 5 - 6 drops, up to 6 years - 15 drops, 12 years - 2 teaspoons 5 times throughout the day.

2. Take 2 teaspoons of birch buds per glass of boiling water and brew this infusion as regular tea. Just drink it in three doses.

3. You can simply eat cloves. but not more than 620 mg with added sugar.

4. If cramps have overcome your legs or arms, you can wipe the corresponding places with mustard oil.

5. You can also use ordinary poppy petals to combat cramps, which we grind into a very fine powder and prepare a decoction with milk and honey. They can also be infused with vodka.

6. For various cramps, a decoction of goose cinquefoil can also be extremely useful. But it is worth keeping in mind that it is used in most cases as a special prophylactic agent, since its effect is long-lasting.

7. It will also be very useful to consume 2 teaspoons of regular honey during meals, and this course has a strictly limited duration, and this is exactly what needs to be done for 7 days.

8. Mix 4 parts olive oil with one part wormwood seeds previously crushed in a mortar. Then we set the whole thing to steep for 8 hours. Then add a couple of drops to the sugar and consume.

9. If you want to use wormwood to combat leg cramps and their causes, then you will need to take 30 grams of the lobes of this medicinal plant per half liter of beer, you can also use vodka. Boil it all for a short time - about 5 minutes and use one tablespoon 3 times a day.

10. Take 4 tablespoons of dried flowers of ordinary chamomile and simply pour a glass of boiling water over them, and then boil the whole thing for 10 minutes and filter. This remedy is always used after eating, a third of a glass 3 times.

11. There are also folk remedies that are not associated with any specific recipes or medicinal herbs, for example, when a cramp occurs, it helps many people to take a stick of simple sealing wax in the hand in which the muscles are spasming. Moreover, it can help other people a lot if you take a piece of iron in the same hand, but it should not be steel or cast iron. A simple pin prick can also immediately stop the leg cramp and its cause.

12. There is also a specialized folk recipe for treating leg cramps with salt, because this is often caused by a lack of salt. Just dissolve half a teaspoon of salt in half a glass of water and drink it all.

But in conclusion, I would still like to note that leg cramps and their triggers and causes can be easily combated using traditional methods, but it will be best if you do not neglect a preliminary consultation with your doctor!

Leg cramps. Causes, symptoms and treatment of pathology

The site provides reference information. Adequate diagnosis and treatment of the disease is possible under the supervision of a conscientious doctor.

Convulsions are a state of continuous contraction of a muscle that cannot be voluntarily relaxed. This condition causes a strong painful reaction, because at the time of cramps the muscle experiences an acute lack of oxygen and nutrients. In addition, in a short period of time it releases a large amount of waste products, which irritate the nerve endings, causing pain.

According to statistics, seizures occur at least once in every person’s life. They become the cause of anxiety when repeated frequently. In some cases, seizures are a symptom of a disease such as epilepsy. In other cases, seizures develop in seemingly healthy people.

Most often, seizures are recorded in people engaged in the following activities:

athletes;
movers;
public transport controllers;
market traders;
water company workers;
swimmers;
surgeons

Interesting Facts

Leg cramps are a signal that there is a certain pathology in the body that causes their appearance.
Cold environments increase the likelihood of cramps.
Smokers experience seizures 5 times more often than non-smokers.
Proper first aid for cramps of the lower extremities prevents their recurrence in 95% of cases.

How do muscles work?

Knowledge of the structure and mechanism of muscle contraction is necessary for an accurate understanding of the causes of the development of leg cramps. Without this information, the ways in which numerous factors influence the occurrence of seizures cannot be fully revealed and explained.

Muscle structure

From the point of view of human physiology, the mechanism of muscle fiber contraction is a long-studied phenomenon. Since the purpose of this article is to highlight the issue of leg cramps, it would be reasonable to pay special attention to the work of only the striated (skeletal) muscles, without affecting the principles of functioning of the smooth ones.

Skeletal muscle consists of thousands of fibers, and each individual fiber, in turn, contains many myofibrils. In a simple light microscope, a myofibril is a strip in which tens and hundreds of nuclei of muscle cells (myocytes) are visible in a row.

Each myocyte has a special contractile apparatus along its periphery, oriented strictly parallel to the cell axis. The contractile apparatus is a collection of special contractile structures called myofilaments. These structures can only be detected using electron microscopy. The main morphofunctional unit of the myofibril with contractility is the sarcomere.

The sarcomere consists of a number of proteins. the main ones are actin, myosin, troponin and tropomyosin. Actin and myosin are shaped like intertwined filaments. With the help of troponin, tropomyosin, calcium ions and ATP (adenosine triphosphate), actin and myosin filaments are brought closer together, as a result of which the sarcomere is shortened, and accordingly the entire muscle fiber.

Mechanism of muscle contraction

There are many monographs describing the mechanism of muscle fiber contraction, in which each author presents his own stages of this process. Therefore, the most correct solution would be to highlight the general stages of the formation of muscle contraction and describe this process from the moment the impulse is transmitted by the brain until the moment of complete muscle contraction.

Muscle fiber contraction occurs in the following order:

The nerve impulse originates in the precentral gyrus of the brain and is transmitted along the nerve to the muscle fiber.
Through the mediator acetylcholine, an electrical impulse passes from the nerve to the surface of the muscle fiber.
The impulse spreads throughout the muscle fiber and penetrates deep through special T-shaped tubules.
Transfer of excitation from T-shaped tubules to cisterns. Tanks are special cellular formations containing large quantities of calcium ions. As a result, calcium channels open and calcium enters the intracellular space.
Calcium triggers the process of mutual convergence of actin and myosin filaments by activating and restructuring the active centers of troponin and tropomyosin.
ATP is an integral component of the above process as it supports the process of bringing together the actin and myosin filaments. ATP promotes the detachment of myosin heads and the release of its active centers. In other words, without ATP, the muscle is not able to contract, since it cannot relax before it does so.
As the actin and myosin filaments come closer together, the sarcomere shortens and the muscle fiber itself and the entire muscle contract.

Factors affecting muscle contractility

Violation at any of the above stages can lead to either a lack of muscle contraction or a state of constant contraction, that is, cramps.

The following factors lead to prolonged tonic contraction of muscle fiber:

excessively frequent brain impulses;
excess acetylcholine in the synaptic cleft;
decreased threshold of myocyte excitability;
decrease in ATP concentration;
a genetic defect in one of the contractile proteins.

Causes of leg cramps

The causes imply diseases or certain conditions of the body that create favorable conditions for the occurrence of cramps of the lower extremities. There are a huge number of diseases and various conditions that can lead to seizures, so in this case one should not deviate from the chosen direction, but, on the contrary, it is necessary to classify diseases according to the factors listed above.

Excessively frequent brain impulses

The brain, namely its special part - the cerebellum, is responsible for maintaining the constant tone of every muscle in the body. Even during sleep, the muscles do not stop receiving impulses from the brain. The fact is that they are generated much less frequently than in the waking state. Under certain circumstances, the brain begins to speed up its impulses, which the patient experiences as a feeling of muscle stiffness. Once a certain threshold is reached, the impulses become so frequent that they maintain the muscle in a state of constant contraction. This condition is called tonic seizures.

Leg cramps due to increased brain impulses develop in the following diseases:

epilepsy;
acute psychosis;
eclampsia;
traumatic brain injury;
intracranial hemorrhage;
cranial thromboembolism.

Epilepsy

Epilepsy is a serious disease characterized by the appearance of foci of synchronous impulses in the brain. Normally, different parts of the brain emit waves of different frequencies and amplitudes. During an epileptic attack, all neurons in the brain begin to pulse synchronously. This causes all the muscles in the body to contract and relax uncontrollably.

There are generalized and partial seizures. Generalized seizures are considered classic and correspond to the name. In other words, they are manifested by contraction of the muscles of the entire body. Partial seizures are less common and involve uncontrolled contraction of only one muscle group or one limb.

There is a special type of seizures, named after the author who described them. The name of these seizures is Jacksonian seizures or Jacksonian epilepsy. The difference between this type of convulsions is that they begin as a partial seizure, for example, from the arm, leg or face, and then spread to the entire body.

Acute psychosis

This mental illness is characterized by visual and auditory hallucinations. caused by many reasons. The pathophysiology of this disease is not well understood, but it is assumed that the substrate for the appearance of symptoms of distorted perception is abnormal brain activity. If medication is not provided, the patient’s condition worsens sharply. A rise in body temperature above 40 degrees is a poor prognostic sign. Often an increase in temperature is accompanied by generalized convulsions. Convulsions of only the lower extremities practically do not occur, but can be the beginning of a generalized attack, as in the above-mentioned Jacksonian seizure.

In addition, the patient may complain that his legs are cramping due to distorted perception. It is important to take this complaint seriously and check whether it is true. If a limb is in a state of cramp, its muscles are tense. Forced extension of the limb leads to the rapid disappearance of painful symptoms. If there is no objective confirmation of cramps of the lower extremities, the patient’s complaints are explained by paresthesia (sensitive hallucinations) caused by acute psychosis.

This pathological condition can occur during pregnancy and poses a serious threat to the life of the pregnant woman and the fetus. In non-pregnant women and men, this disease cannot occur, since the triggering factor for its development is the incompatibility of certain cellular components of the mother and fetus. Eclampsia is preceded by preeclampsia, in which the pregnant woman's blood pressure increases. swelling appears and general health worsens. With high blood pressure numbers (on average 140 mm Hg and above), the risk of placental abruption increases due to the narrowing of the blood vessels that supply it. Eclampsia is marked by the appearance of generalized or partial seizures. Leg cramps, as in the previous case, may be the beginning of a partial Jacksonian seizure. During convulsions, sharp contractions and relaxations of the uterine muscles occur, leading to detachment of the fetal place and cessation of nutrition of the fetus. In this situation, there is an urgent need for emergency delivery by cesarean section in order to save the life of the fetus and stop uterine bleeding in the pregnant woman.

Traumatic brain injury

Traumatic brain injuries can lead to leg cramps, but it should be recognized that this happens quite rarely. There is a pattern according to which the size of the lesion corresponds to the severity of seizures and the duration of their manifestation. In other words, a brain contusion with a subdural hematoma is more likely to cause seizures than a normal concussion. The mechanism of seizures in this case is associated with the destruction of brain cells. The ionic composition of the lesion changes, which leads to a change in the excitability threshold of surrounding cells and an increase in the electrical activity of the affected area of the brain. So-called foci of epileptic activity of the brain are formed, which are periodically discharged by convulsions and then accumulate a charge again. As the area affected by the injury heals, the ionic composition of brain cells also normalizes, which inevitably leads to the disappearance of the focus of high convulsive activity and the cure of the patient.

Intracranial hemorrhage

Intracranial hemorrhage is often a complication of hypertension. in which aneurysms (areas of thinned vascular wall) form over time in the vessels of the brain. Almost always, intracranial hemorrhage is accompanied by loss of consciousness. With the next rise in blood pressure, the aneurysm ruptures and blood escapes into the brain matter. Firstly, the blood puts pressure on the nervous tissue, thus violating its integrity. Secondly, the ruptured vessel for some time loses the ability to supply blood to a certain area of the brain, leading to oxygen starvation. In both cases, brain tissue is damaged either directly or indirectly by a change in the ionic composition of the intercellular and intracellular fluid. There is a decrease in the threshold of excitability in the focus of the affected cells and the formation of a zone of high convulsive activity. The more massive the hemorrhage, the more likely it is to lead to seizures.

Cranial thromboembolism

Control of this disease is extremely important in modern society, since it is caused by a sedentary lifestyle, excess weight, poor diet, smoking and alcohol abuse. Through a variety of mechanisms, blood clots (thrombi) form in any part of the body, which grow and can reach quite large sizes. Due to their anatomical features, the veins of the legs are the most common place for blood clots to form. Under certain circumstances, a blood clot breaks off and, reaching the brain, clogs the lumen of one of the vessels. After a short time (15–30 seconds), symptoms of hypoxia of the affected area of the brain appear. Most often, hypoxia of a certain area of the brain leads to the disappearance of the function that it provides, for example, loss of speech, disappearance of muscle tone, etc. However, sometimes the affected area of the brain becomes a focus of high convulsive activity, which was mentioned earlier. Leg cramps most often occur when blood vessels supplying the lateral part of the precentral gyrus are blocked by a blood clot, since it is this part of the brain that is responsible for voluntary movements of the legs. Restoring the blood supply to the affected area leads to its gradual resorption and the disappearance of seizures.

Excess acetylcholine in the synaptic cleft

Acetylcholine is the main transmitter involved in the transmission of impulses from the nerve to the muscle cell. The structure that ensures this transmission is called an electrochemical synapse. The mechanism of this transmission is the release of acetylcholine into the synaptic cleft, followed by its action on the muscle cell membrane and the generation of an action potential.

Under certain conditions, an excess of transmitter can accumulate in the synaptic cleft, inevitably leading to more frequent and stronger muscle contractions, up to the development of convulsions, including in the lower extremities.

The following conditions cause seizures by increasing the amount of acetylcholine in the synaptic cleft:

overdose of drugs from the group of cholinesterase blockers;
muscle relaxation with depolarizing drugs;
magnesium deficiency in the body.

Overdose of drugs from the group of cholinesterase blockers

Cholinesterase is an enzyme that breaks down acetylcholine. Thanks to cholinesterase, acetylcholine does not stay long in the synaptic cleft, which results in muscle relaxation and rest. Drugs from the group of cholinesterase blockers bind this enzyme, leading to an increase in the concentration of acetylcholine in the synaptic cleft and an increase in the tone of the muscle cell. According to the mechanism of action, cholinesterase blockers are divided into reversible and irreversible.

Reversible cholinesterase blockers are used primarily for medical purposes. Representatives of this group are prozerin, physostigmine, galantamine, etc. Their use is justified in the case of postoperative intestinal paresis. in the recovery period after a cerebral stroke, with atony of the bladder. An overdose of these medications or their unjustified use first leads to a feeling of painful muscle stiffness, and then to cramps.

Irreversible cholinesterase blockers are otherwise called organophosphates and belong to the class of chemical weapons. The most well-known representatives of this group are the chemical warfare agents sarin and soman, as well as the familiar insecticide dichlorvos. Sarin and soman are banned in most countries of the world as inhumane weapons. Dichlorvos and other related compounds are often used in households and cause household poisoning. The mechanism of their action is the strong binding of cholinesterase without the possibility of its independent detachment. The bound cholinesterase loses its function and leads to the accumulation of acetylcholine. Clinically, spastic paralysis of the entire body muscles occurs. Death occurs from paralysis of the diaphragm and disruption of the process of voluntary breathing.

Muscle relaxation with depolarizing drugs

Muscle relaxation is used when performing anesthesia before surgery and leads to better anesthesia. There are two main types of muscle relaxants - depolarizing and non-depolarizing. Each type of muscle relaxant has strict indications for use.

The most famous representative of depolarizing muscle relaxants is suxamethonium chloride (ditylin). This drug is used for short operations (maximum 15 minutes). After recovering from anesthesia with the parallel use of this muscle relaxant, the patient feels muscle stiffness for some time, as after heavy and prolonged physical work. In combination with other predisposing factors, the above sensation can turn into convulsions.

Magnesium deficiency in the body

Magnesium is one of the most important electrolytes in the body. One of its functions is to open the channels of the presynaptic membrane for the return entry of unused transmitter into the axon terminal (the central process of the nerve cell responsible for transmitting the electrical impulse). With a lack of magnesium, these channels remain closed, which leads to the accumulation of acetylcholine in the synaptic cleft. As a result, even light physical activity provokes seizures after a short time.

Magnesium deficiency often develops due to poor nutrition. This problem mainly affects girls who seek to limit themselves in food for the sake of their figure. Some of them, in addition to diet, use adsorbents, the most famous of which is activated carbon. This drug is certainly extremely effective in many situations, but its side effect is the removal of beneficial ions from the body. With one-time use, seizures do not occur, but with prolonged use, the risk of their occurrence increases.

Decreased myocyte excitability threshold

A muscle cell, like any other cell in the body, has a certain threshold of excitability. Despite the fact that this threshold is strictly specific for each type of cell, it is not constant. It depends on the difference in the concentration of certain ions inside and outside cells and the successful operation of cellular pumping systems.

The main reasons for the development of seizures due to a decrease in the threshold of myocyte excitability are:

electrolyte imbalance;
hypovitaminosis.

Electrolyte imbalance

The difference in the concentration of electrolytes creates a certain charge on the surface of the cell. In order for a cell to become excited, it is necessary that the impulse it receives be equal to or greater in strength than the charge of the cell membrane. In other words, the impulse must overcome a certain threshold value in order to bring the cell into a state of excitation. This threshold is not stable, but depends on the concentration of electrolytes in the space surrounding the cell. When the electrolyte balance in the body changes, the threshold of excitability decreases, weaker impulses cause muscle contraction. The frequency of contractions also increases, which leads to a state of constant excitation of the muscle cell - convulsions. Disorders that often lead to changes in electrolyte balance are vomiting. diarrhea. bleeding, shortness of breath and intoxication.

Hypovitaminosis

Vitamins play an extremely important role in the development of the body and maintaining its normal performance. They are part of enzymes and coenzymes that perform the function of maintaining the constancy of the internal environment of the body. The contractile function of muscles is largely affected by a deficiency of vitamins A, B, D and E. In this case, the integrity of cell membranes suffers and, as a result, a decrease in the threshold of excitability occurs, leading to convulsions.

Decrease in ATP concentration

ATP is the main chemical carrier of energy in the body. This acid is synthesized in special organelles - mitochondria, present in every cell. Energy is released when ATP is broken down into ADP (adenosine diphosphate) and phosphate. The released energy is spent on the operation of most systems that maintain cell viability.

In a muscle cell, calcium ions normally lead to its contraction, and ATP is responsible for relaxation. If we consider that a change in the concentration of calcium in the blood extremely rarely leads to seizures, since calcium is not consumed or formed during muscle work, then a decrease in the concentration of ATP is the direct cause of seizures, since this resource is consumed. It should be noted that cramps develop only in the case of extreme depletion of ATP, which is responsible for muscle relaxation. Restoring ATP concentration requires a certain time, which corresponds to rest after hard work. Until the normal ATP concentration is restored, the muscle does not relax. It is for this reason that an overworked muscle is hard to the touch and rigid (difficult to straighten).

Diseases and conditions leading to a decrease in ATP concentration and the appearance of seizures are:

Diabetes mellitus is a severe endocrine disease leading to a number of acute and delayed complications. Diabetes requires high discipline from the patient, since only the right diet and timely intake of medications in the required concentration can compensate for the lack of insulin in the body. However, no matter how much effort the patient makes to control glycemic levels, he will not be able to completely avoid surges in blood glucose concentrations. This is explained by the fact that this level depends on many factors that are not always controllable. These factors include stress. time of day, composition of food consumed, type of work performed by the body, etc.

One of the serious complications that develops in diabetes mellitus is diabetic angiopathy. As a rule, with good control of the disease, angiopathy develops no earlier than in the fifth year. There are micro and macro angiopathy. The mechanism of the damaging action consists in damage, in one case, to the main main vessels, and in the other, to small vessels that nourish the tissues of the body. The muscles that normally consume most of the energy begin to suffer from insufficient blood circulation. When there is a lack of blood circulation, less oxygen reaches the tissues and less ATP is produced, particularly in muscle cells. According to the previously mentioned mechanism, a lack of ATP leads to muscle spasm.

Inferior vena cava syndrome

This pathology is typical only for pregnant women and develops, on average, from the second half of pregnancy. By this time, the fetus has reached a size sufficient to begin to gradually displace the mother’s internal organs. Along with the organs, large vessels of the abdominal cavity are also compressed - the abdominal aorta and the inferior vena cava. The abdominal aorta has a thick wall and also pulsates, which does not allow blood stagnation to develop at this level. The wall of the inferior vena cava is thinner, and the blood flow in it is laminar (constant, not pulsating). This makes the venous wall vulnerable to compression.

As the fetus grows, compression of the inferior vena cava increases. Along with this, circulatory disorders in this segment also progress. Blood stagnates in the lower extremities and edema develops. In such conditions, tissue nutrition and oxygen saturation gradually decrease. These factors together lead to a decrease in the amount of ATP in the cell and an increase in the likelihood of developing seizures.

Chronic heart failure

This disease is characterized by the inability of the heart to sufficiently perform its pumping function and maintain an optimal level of blood circulation. This leads to the development of edema, starting in the lower extremities and rising higher as the impairment of cardiac function progresses. Under conditions of blood stagnation, a deficiency of oxygen and nutrients develops in the lower extremities. Under such conditions, the performance of the muscles of the lower extremities is noticeably reduced, ATP deficiency occurs faster and the likelihood of seizures increases.

Phlebeurysm

Varicose veins are areas of thinned venous wall that protrude beyond the normal contours of the vessel. It develops more often in people whose occupation involves standing for many hours, in patients with chronic heart failure, and in obese patients. In the first case, the mechanism of their development is associated with a constantly increased load on the venous vessels and their expansion. In case of heart failure, blood stagnation develops in the vessels of the lower extremities. With obesity, the load on the legs increases significantly, the blood volume increases, and the diameter of the veins is forced to adapt to it.

The speed of blood flow in varicose veins decreases, the blood thickens, and blood clots form, clogging those same veins. Under such conditions, the blood seeks another outflow path, but soon high pressure there leads to the appearance of new varicose veins. This closes a vicious circle, the result of which is the progression of blood stagnation in the lower extremities. Blood stagnation leads to decreased ATP production and an increased likelihood of seizures.

Thrombophlebitis

Thrombophlebitis is inflammation of a venous vessel. As a rule, thrombophlebitis accompanies varicose veins, since the mechanisms of their formation overlap. In both cases, the triggering factor is stagnation of blood circulation. With varicose veins, it leads to dilation of the veins, and with thrombophlebitis, it leads to inflammation. The inflamed vein is compressed by edema and becomes deformed, causing its throughput to suffer, blood stagnation to worsen, and inflammation to progress again. Another vicious circle leads to the fact that it is almost impossible to completely cure thrombophlebitis and varicose veins using a conservative method. When using certain medications, it is possible to achieve a reduction in inflammation, but not the disappearance of the factors that caused it. The mechanism of seizures, as in previous cases, is associated with stagnation of blood in the lower extremities.

Obliterating atherosclerosis

This disease is the scourge of countries with a high level of development, since its incidence and severity grows along with the level of well-being of the population. It is in these countries that the percentage of obese people is highest. With excess nutrition, smoking and a sedentary lifestyle, atherosclerotic plaques form on the walls of the arteries, reducing the patency of blood vessels. Their most common locations are the iliac, femoral and popliteal arteries. As a result of plaque formation, the arterial capacity becomes limited. If, under normal load, muscle tissue receives enough oxygen and nutrients, then with increasing load, their deficiency gradually develops. A muscle that does not receive enough oxygen produces less ATP, which after a certain time, provided the intensity of work is maintained, will lead to the development of leg cramps.

Anemia is a decrease in the number of red blood cells (erythrocytes) and/or hemoglobin in the blood. Red blood cells are cells containing up to 98% hemoglobin protein, and he, in turn, is able to bind oxygen and transport it to peripheral tissues. Anemia can develop for many reasons, such as acute and chronic bleeding, disruption of the maturation of red blood cells, a genetic defect in hemoglobin, long-term use of certain medications (pyrazolone derivatives) and much more. Anemia leads to decreased gas exchange between air, blood and tissues. The amount of oxygen supplied to the periphery is insufficient to meet the optimal needs of the muscles. As a result, fewer ATP molecules are formed in mitochondria, and its deficiency increases the risk of developing seizures.

Early postoperative period

This condition is not a disease, but deserves close attention when it comes to seizures. Operations of moderate and high degrees of complexity are usually accompanied by some blood loss. In addition, blood pressure can be artificially reduced for a long time for special stages of the operation. The mentioned factors, combined with complete immobility of the patient during several hours of surgery, create an increased risk of blood clots in the lower extremities. This risk increases in patients with atherosclerosis or varicose veins.

The postoperative period, which in some cases takes quite a long time, requires the patient to adhere to strict bed rest and little physical activity. Under these conditions, blood circulation in the lower extremities slows down significantly, and blood clots or blood clots form. Blood clots partially or completely block the blood flow in the vessel and cause hypoxia (low oxygen content in the tissues) of the surrounding muscles. As in previous diseases, a decrease in oxygen concentration in muscle tissue, especially under conditions of increased stress, leads to the appearance of cramps.

Hyperthyroidism

Hyperthyroidism is a disease associated with increased production of thyroid hormones. Based on the cause and mechanism of development, primary, secondary and tertiary hyperthyroidism are distinguished. Primary hyperthyroidism is characterized by a disorder at the level of the thyroid gland itself, secondary – at the level of the pituitary gland and tertiary – at the level of the hypothalamus. An increase in the concentration of the hormones thyroxine and triiodothyronine leads to tachypsychia (acceleration of thought processes) as well as restlessness and a state of constant anxiety. These patients are much more active than healthy people. The excitability threshold of their nerve cells decreases, which leads to an increase in cell excitability. All of the above factors lead to more intense muscle work. In combination with other predisposing factors, hyperthyroidism may well cause seizures.

Excessive exercise

Excessive and prolonged physical activity is definitely harmful for an unprepared body. The muscles are quickly depleted, and the entire ATP supply is used up. If you do not provide the muscles with time to rest, during which a certain amount of these energy carriers is synthesized again, then with further muscle activity the development of cramps is very likely. Their likelihood increases many times in a cold environment, for example, in cold water. This is due to the fact that cooling the muscle leads to a decrease in the metabolic rate in it. Accordingly, ATP consumption remains the same, and the processes of its replenishment slow down. This is why seizures occur quite often in water.

Flat feet

This pathology consists of improper formation of the arch of the foot. As a result, the foot's support points end up in places that are physiologically unsuitable for them. The muscles of the foot located outside the arch have to bear a load for which they are not designed. As a result, they quickly become tired. A tired muscle is deprived of ATP and at the same time loses its ability to relax.

In addition to damage to the foot itself, flat feet indirectly affects the condition of the knee and hip joints. Since the arch of the foot is not formed correctly, it does not perform a shock-absorbing function. As a result, the above joints are subject to greater shock and are more likely to fail, causing the development of arthrosis and arthritis.

Genetic defect in one of the contractile proteins

This category of diseases is classified as incurable. It is comforting to know that the frequency of the disease in the population is low and the probability of the disease occurring is 1:200 - 300 million. This group includes various enzymopathies and diseases of abnormal proteins.

One of the diseases in this group, manifested by seizures, is Tourette's syndrome (Gilles de la Tourette). Due to the mutation of specific genes in the seventh and eleventh pairs of chromosomes, abnormal connections are formed in the brain, leading to the appearance of involuntary movements (tics) and cries (usually obscene) in the patient. In cases where the tic affects the lower limb, it may manifest itself in the form of periodic seizures.

First aid for a seizure

The main task of a person helping himself or someone else with a cramp is to recognize the cause of the cramp. In other words, it is necessary to distinguish whether a seizure is a manifestation of a partial epileptic seizure or is caused by some other reason. Depending on the mechanism of development of seizures, there are at least two algorithms for providing assistance, which are radically different from each other.

The first distinctive feature of epileptic seizures is the staged nature. The first stage is clonic, that is, it is manifested by alternating rhythmic contractions and relaxation of muscles. The duration of the clonic stage is, on average, 15–20 seconds. The second stage of epileptic seizures is tonic. With it, a prolonged muscle spasm occurs, on average, up to 10 seconds, after which the muscle relaxes and the attack ends.

The second feature of epileptic seizures is the dependence of their appearance on certain triggering factors that are strictly individual for each patient. The most common of these are bright flickering lights, loud sounds, and a certain taste and smell.

The third feature appears only in the case of the transition of partial seizures to generalized ones and consists in the loss of consciousness of the patient at the end of the attack. Loss of consciousness is often accompanied by involuntary urination and passing of stool. After regaining consciousness, the phenomenon of retrograde amnesia is observed. in which the patient does not remember that he suffered an attack.

If, according to the above criteria, the patient has a partial attack of epileptic seizures, he, first of all, must be seated on a chair, bench or ground to avoid injury in the event of a possible fall. Next, you should wait until the attack ends without taking any action.

If convulsions spread and become generalized, it is necessary to lay the patient on his side and place a blanket, a shirt under his head, or wrap his arms around it to avoid damage during an attack. It is important not to fix the head, but rather to protect it from blows, since with strong fixation there is a risk of collapsing the cervical vertebrae, which inevitably leads to the death of the patient. If a patient has a generalized attack of convulsions, it is equally important to call an ambulance as soon as possible, since without the administration of certain medications there is a high probability of repeated convulsions. After the attack ends, you must try to find out what factor could have triggered the attack and try to eliminate it.

When the cause of seizures is not related to epilepsy, the following measures must be taken. First, you need to give your limbs an elevated position. This ensures improved blood flow and eliminates stagnation. Secondly, you should grab your toes and dorsally flex the foot (towards the knee) in two stages - first bend halfway and release, and then slowly bend again as much as possible and hold in this position until the cramps stop. This manipulation leads to forced stretching of the muscle, which, like a sponge, draws in oxygen-rich blood. At the same time, it is useful to perform a light massage of the limb, as it improves microcirculation and speeds up the recovery process. Pinches and injections have a distracting effect and interrupt the reflex chain that closes with pain from muscle spasm.

Treatment of seizures

Treatment of seizures should follow the following rule. An attack of convulsions must be stopped first, since it is a stressful condition for the body. The causes that caused it are treated secondarily. If the causes cannot be eliminated, the patient should receive constant pathogenetic and symptomatic treatment aimed at reducing the likelihood and severity of seizures.

Drug treatment for frequent seizures

Drug treatment of seizures is conventionally divided into interrupting seizures and treatment aimed at preventing them.

Drug intervention is performed only if the patient has a partial or generalized epileptic seizure. For convulsions of a different origin, they are interrupted using the manipulations indicated in the section “First aid for convulsions.”

Drugs used to relieve an attack of epileptic seizures

Health, life, hobbies, relationships

seizures after stroke

Seizures are a complex response to internal or external stimuli. The reason is different in each case. Essentially, cramps are involuntary contractions of skeletal muscles that are paroxysmal in nature. They may vary in prevalence, intensity and duration. Seizure attacks can be regular or episodic. Depending on the duration of the contraction, a distinction is made between tonic and clonic.

Clonic is a short-term contraction and relaxation of individual muscles. They look like fast movements. For example, a tick on half the face or eyelid.

Tonic – rather long contractions (up to three minutes or more). They feel like muscle hardening. At such a moment, it is impossible to control the contracted muscles.

Reasons why seizures may occur.

One of the reasons for the appearance of seizures may be a focus of irritation that appears in the motor zone of the brain. This happens during an incipient stroke or during recovery after an attack. The location of the cramps in specific muscles depends on how the area of the brain is stimulated. If there is a suspicion of such a mechanism of muscle contractions, then you should immediately seek help from specialists.

How to identify the cause of the seizures.

At the beginning, you can immediately discard or establish the obvious reasons: long strenuous physical work, stuffiness or overheating. Or any viral infection.

What to do during seizure attacks.

You need to stand on the cold floor and walk around a little.

Lie down and stretch your leg.

Painful muscles need to be rubbed.

You should also mix one teaspoon of olive oil and two teaspoons of mustard and spread this paste on the area where the cramp occurred.

It is also necessary to take a painkiller, aspirin, it will additionally improve microcirculation in the vessels of the legs.

Treatment outside of an attack

A person must make adjustments to his lifestyle.

You should avoid drinking strong tea and coffee, and also stop smoking - these factors can provoke seizures. If a person takes steroid hormones and diuretics, the frequency and dose of their use should be reduced.

You need to drink plenty of fluids. But not sweet carbonated drinks, but water, preferably mineral water.

The menu should be adjusted: eat more vegetables and leafy greens, they supply minerals to the human body.

Women during menopause should take additional calcium and magnesium supplements.

In order to normalize calcium metabolism, vitamin D should be used.

Live healthy!: Cramps 09/27/2013

Seizures after a stroke most often appear if the patient has a seizure with a focus in the frontal lobe of the brain. This problem can occur during acute circulatory disorders in the brain and several months after the attack during the period of exacerbation of the disease.

The resumption of symptoms does not indicate improper therapy, but the development of a second attack, a large area of necrosis, or the formation of a cyst-like cavity in place of dead tissue.

What Causes Cramps

Seizures may occur after an ischemic or hemorrhagic stroke. They are the result of the death of neurons in the brain. When foci of necrosis begin to form, the body tries to stop the damage and restore normal blood circulation in the brain. This task is accomplished by distributing dead neurons among brain cells.

Such self-defense leads to the formation of cavities with liquid in place of dead tissue. This formation does not cause discomfort, but sometimes it irritates neurons, which is accompanied by seizures.

Seizures after a stroke can be triggered by:

Emotional stress.
Physical or psychological fatigue.
As a side effect after taking certain medications.

The main reasons for the development of seizures are considered to be the occurrence of cysts, adhesions and other neoplasms in areas of dead tissue.

Main symptoms of seizures

During cramps, certain muscle groups contract or twitch. The duration of this phenomenon ranges from several seconds to ten minutes.

After an attack of acute circulatory disorders in the brain, the patient most often suffers from short-term convulsions throughout the body. They can occur in the arms, legs, face or neck. After an attack of convulsions, the patient loses consciousness or falls asleep as a result of the brain being in a state of shock.

Seizures can manifest themselves in different ways. Some patients experience mild tremors, while others suffer from severe seizures.

Seizures during and after a stroke can manifest themselves as follows:

the facial muscles contract for a short time. In this case, one half of the face may become distorted, resulting in a mask-like face;
the muscles of the limbs go numb, and the person completely loses control over them. There is a feeling of a wooden arm or leg;
contraction of the facial muscles may be accompanied by numbness of the limbs.

If an attack occurs, you must urgently call an ambulance.

How to providefirst aid

Every person should know what to do if seizures occur. If a loved one or stranger has an attack, you must:

Provide him with oxygen. If this happened indoors, then you need to open the windows, otherwise you should remove tight clothes from the patient.
A cushion or pillow should be placed under the patient's head.
If you have dentures in your mouth, or if an attack occurs while eating, it is necessary to clear the oral cavity of foreign objects.
If the victim begins to breathe hoarsely, he should be placed on his side and checked to ensure that nothing is obstructing his breathing.
If pain develops in muscle tissue, you need to massage and warm up the muscles well. It is advisable to lubricate the skin with olive oil mixed with mustard before the massage.
The patient should take aspirin, which will help him get rid of heat and tension and improve blood circulation in the vessels.
Even if the attack has stopped, it is necessary to call a specialist.

Seizures are treated in eight percent of cases. If they increase, it means that the treatment of the stroke did not produce results, and the focus of necrosis increases.

Treatment of post-stroke attacks involves the use of one or more medications. Most often, the patient's condition is alleviated with the help of Finlepsin or Carbamazeline. Most doctors prefer to treat with Finlepsin. It most often gives a positive result and can almost completely relieve attacks.

At the beginning of therapy, the patient should consume no more than two hundred milligrams of the drug per day. But it is not advisable to carry out treatment with this drug without consulting a doctor, since the drug may cause some adverse reactions. In most cases they manifest themselves:

decrease in intellectual activity. This side effect develops if the patient takes the medicine for a long time;
powerlessness, apathy, complete calm;
osteoporosis or increased bone fragility. This problem can be compensated for with calcium supplements;
increased risk of bleeding. This problem may occur if Finlepsin is combined with anticoagulants.

Treatment with this remedy is only suitable for people under 65 years of age. A maximum of 400 mg of the drug can be consumed per day. There are analogues of the product that have a more gentle effect. These drugs can be addictive, so it is necessary to change the medication periodically. Any therapy should be carried out only under the supervision of the attending physician. He will be able to notice in time the development of a recurrent stroke attack and prescribe appropriate treatment.

2556. Ilya | 30.11.2013, 18:40:34

Listen, please, everyone!

I myself am an instructor in restoring movements using wave techniques, and the author of the insult5.ru project.

2557. Ilya | 30.11.2013, 18:40:50

In addition, the muscles on the affected side are weak, atrophied, and it is basically impossible to strengthen them with pills, injections, or massagers.

We have a technique, a training video, and results for a 68-year-old man, after a terrible hemorrhagic stroke and paralysis, after 5 months. classes, the abs pump, and he walks with light support.

Our other student (54 years old, with craniotomy, movement coordination disorder, barely able to move, with severe spasticity of the arm and paralysis of the leg) after 3 weeks of classes began to stand up on his own without support and stand upright (classes continue)

Another client (72 years old, ischemic stroke 3 years ago, lack of any rehabilitation, contracture + paralysis of the left arm) during the 2nd lesson was able to move it to a bend, 10 cm, and lift it by 5 cm.

So, dear forum users! From my own experience, I want to say (I can no longer remain silent, reading some comments) MOVEMENT DISORDER IS TREATED MAINLY BY CORRECTLY ORGANIZED, GENTLE MOVEMENT, A COMBINATION OF DYNAMIC AND WAVE LOAD. (And the fact that they grumble and sometimes make you nervous with their behavior - they are like children, they don’t need pity, and not punishment in the form of: “Oh, you’re like that! I won’t come!” THEY ONLY NEED HELP IN RESTORING MOTOR SKILLS, THE REST THEY WILL DO IT THEMSELVES: go to the toilet, shave, eat, etc.

I don't want to be unfounded. And I suggest that those who really need help here, and not “just complain,” take a course to restore movements at home. Go here: insult5.ru. I myself will guide you, advise you, and send you the necessary exercises. And you will post here on the forum about the results. This will help you and give hope to many other people. I can help those in Moscow personally.

Articles

Exercises to restore movement in the hand

There are many literary sources and publications that describe exercises aimed at restoring hand function. However, the bulk of the recommendations are suitable for people whose motor functions have not been completely lost.

We will try to describe recovery process. starting with a complete lack of movement in the affected arm.

Hand exercises need to start right away after paralysis. At the first stage, the main tasks of rehabilitation of the upper limb are:

1. Prevention of joint stiffness in the affected limb by performing passive movements in all joints of the paralyzed arm. Passive movements should be performed repeatedly throughout the day.

2. Slowing down the process of muscle atrophy: if there are no contraindications, then massage and electrical myostimulation are performed.

3. Prevention of injuries and sprains of the joint capsule of the shoulder joint: when the patient takes a vertical position, the sore arm should be placed in a shoulder scarf and fixed to the body.

1. Flexion - extension of the arm at the elbow.

2. The arm is bent at the elbow, straightening the arm upward.

3. The arm is bent at the elbow, the shoulder is moved to the side, the arm is straightened upward.

6. Flexion - extension in the wrist joint.

7. Squeezing - unclenching fingers.

8. Adduction - abduction and opposition of the thumb.

All exercises are performed passively (with outside help). The number of repetitions in each exercise is at least 50 times.

As active movements appear in the paralyzed arm, they begin to add to the set of exercises active-passive exercises. which are performed with outside help or with the help of a healthy limb.

When active movements occur in the affected limb, special attention should be paid correctness of the restored movements.

As a rule, people, not knowing the intricacies of the recovery process, are happy about any movements that appear and begin to actively develop them - this is main mistake. because in most cases, the first movements that appear are incorrect. Consolidation of incorrect movements leads to the appearance of spasticity and the formation of spastic contractures and stiffness of the joints.

Examples of active-passive exercises in a supine position:

1. Bend your arms at the elbows.

2. Arms bent at the elbows in front of the chest, straightening the arms upward.

3. Raising straight arms up.

Exercises can be performed by keeping your fingers in the “lock” position or fixing the affected limb (with an elastic bandage) to a gymnastic stick.

As the patient recovers, exercises begin to be performed from a sitting and standing position, which allows for more amplitude movements.

Restoring hand and finger movements

The most labor-intensive process is restoration of fine motor skills.

Many patients who have suffered a stroke, traumatic brain injury, or brain surgery develop spastic flexion contractures of the hand and fingers. Before you begin to restore movement, you must remove pathological tone and develop contractures. Spasticity is relieved with the help of muscle relaxants, massage and physiotherapeutic procedures.

Development of contractures- the process is painful and traumatic: not every person is ready to endure significant pain. When the patient experiences pain, the tone in the affected arm increases, which is why pain occurs when the joints develop.

This vicious circle can be overcome by correctly calculated scheme of rehabilitation measures. which includes:

- massage;

— deep warming of spastic muscle groups and developed joints;

— electromyostimulation of antagonist muscles;

— passive development of movements in the joints;

— staged fixation of the limb in extreme positions using individual splints.

Let's take a closer look at these procedures.

1. Massage can be performed with the addition of warming ointments. The main goal of massage is to stimulate blood flow to the massaged area, warm up and give elasticity to the ligaments that are planned to be developed.

2. Deep heating carried out using physiotherapeutic paraffin and ozokerite applications. Prolonged exposure to heat reduces spasticity and promotes muscle relaxation. Working out the joint after warming up is less painful.

3. Electromyostimulation of antagonist muscles- this is the stimulation of muscle groups opposite to the muscles in spasticity. Thus, a balance is gradually formed between these muscle groups.

4. Passive development of the joint- gradual stretching of the spasmed muscle, as well as contracted ligaments. With the help of repeatedly repeated passive movements, with a gradually increasing amplitude, the range of movements in the joint increases, the muscles and ligaments become more elastic.

5. After the development of the joint is completed, the hand and fingers must fix in extension position. to the maximum angle. Fixation can be achieved using orthoses for the wrist joint. as well as splints made from plaster or polymer bandages.

As the range of motion of the limb being developed increases, the splints must be changed.

This scheme for the development of spastic contractures allows quickly achieve stable results. while causing minimal pain to the patient.

Restoring hand and finger movements begins with active-passive exercises. After movements of all fingers and movements in the wrist joint have been restored, proceed to restoration of fine motor skills and individual finger movements: for example, learning to pick up and carry objects. The smaller the object, the more difficult it is to grasp and hold.

An approximate set of exercises aimed at restoration of basic movements in the elbow, hand and fingers(exercises are performed while sitting at a table):

1. Flexion - extension of the arm at the elbow along the table surface.

2. Bend the arm at the elbow towards the shoulder, without lifting the elbow from the table.

3. Sliding your hand back and forth across the table.

4. Circular movements of the hand along the surface of the table.

5. Turn the hand palm up.

6. The brush hangs from the table, lifting the brush.

7. Squeezing - unclenching the fingers, palm on the table surface.

8. Clenching and unclenching your fingers, palm up.

Relieving spasticity after a stroke turned out to be extremely difficult. The point is a contradiction that arises. We stubbornly restored strength and endurance. They did this with the help of special exercises with high loads and a lot of repetitions. For the treatment of spasticity, this is a hindrance and harm. When relieving spasticity, you need a relaxing massage and light movements in the exercises. To continue recovery after a stroke, it is necessary to carry out mutually exclusive activities. Quite a puzzle. But we came up with a simple solution. Make two groups of classes. First: to restore strength and endurance. The second is for treating spasticity, restoring balance and coordination. The decision turned out to be very correct. True, we did not figure it out right away and for some time we did exercises to relieve spasticity along with exercises for strength and endurance. We noticed in time that active exercises made the spasticity worse.

It became harder to do the exercises. Fatigue has increased. Pain in muscles and joints appeared. This made us realize that we were doing something wrong. The error was corrected by dividing classes on different days. We started with exercises to remove

Exercise 1.

Perform while sitting, with your right hand.

We relax the left hand and hold it without movement in a comfortable position.

At first she was also tense. This needs to be controlled and relaxed.

20 reps x 3 sets.

Exercise 2.

Perform while sitting, with your left hand.

We relax the right hand and hold it without movement in a comfortable position.

Alternately touching the tip of the thumb with the tips of the other fingers.

We touch the tip of the thumb in order: index, middle, ring and little fingers.

Without pause, we continue touching in the opposite direction.

We touch the tip of the thumb in reverse order: ring, middle and index.

20 reps x 3 sets.

We make movements slowly, smoothly and precisely. We do not strain our hand, the touch of our fingers is barely perceptible.

Exercise 3.

Perform while sitting, with your left and right hands at the same time. Synchronously.

Alternately touching the tips of the thumbs on both hands with the tips of the remaining fingers.

We touch the tip of the thumb in order: index, middle, ring and little fingers.

Without pause, we continue touching in the opposite direction.

We touch the tip of the thumb in reverse order: ring, middle and index.

20 reps x 3 sets.

We make movements slowly, smoothly and precisely. We don’t strain our hands, the touch of our fingers is barely noticeable.

The exercises seem simple. Despite this, they must be done with concentration and attention. The option of combining it with watching TV is no longer necessary. Any distraction prevents you from performing the exercises correctly. Mistakes will be fixed in the brain. We'll have to relearn. Correcting a fixed, erroneous skill is a thankless task. Loss of energy and precious time. Tested on me))).

In addition to relieving spasticity, it is great to practice coordination of finger movements.

The most difficult thing was performing the exercise with both hands at the same time. Slightly less difficult with the left hand.

At first, it is not speed that is important, but accuracy. The brain needs to remember the correct movements. No mistakes. As you master the exercise, gradually increase the speed. The main thing is quality, accuracy and correct order of touches. If during the exercises there was excess tension in the hand, shake the hand two or three times to relax, and after relieving the tension, continue. Movements should be light. This is the essence of the exercises.

Stroke represents one of the most important modern medical problems. Strokes are the main cause of long-term disability. According to statistics, 85% of people who have suffered a stroke require an intensive course of restoration of functional changes. Simply put, a third of patients who do not receive proper medical care after a stroke become disabled. To avoid this, you must immediately seek medical help and undergo a course of treatment and rehabilitation.

The first three months after the onset of a stroke, muscle tone increases in paretic (paralyzed) limbs, and mild muscle spasticity appears.

At this stage it is not a pathology. However, an increase in muscle tone leads to pronounced attacks of muscle spasms and the development of their contractures. To fully restore the patient, it is necessary to relieve muscle spasticity, otherwise he will not only lose his ability to work, but also will not be able to independently care for himself in everyday life.

Treatment of spasticity after stroke

Recovery after a stroke is impossible without stopping muscle spasticity. At the first stage of rehabilitation, a number of exercises are used to reduce it: the patient is placed in various positions, thanks to which the spasms go away. These exercises can only be performed by qualified medical personnel and in conjunction with physiotherapy, which includes paraffin heat therapy, application and similar manipulations. Manual therapy, gymnastics and medical massage are of great importance in reducing muscle spasticity.

In some cases, surgical treatment of muscle spasticity is prescribed; during rehabilitation after a stroke, this treatment method is practically not used.

Three months after a stroke, muscle spasticity is unacceptable. It is at this time that muscle relaxants play a vital role in restoring the normal functioning of the limbs. With their help, you can reduce the tone of the striated muscles, reducing the motor activity of the muscles, up to the complete elimination of their contractions. Muscle relaxants are injected into the areas of problematic limbs. Only the supervising neurologist determines the need for drug treatment, and only after three months have passed since the onset of the stroke.

Treatment with Dysport

One of the effective muscle relaxants used in our country is Dysport. Dysport is a botulinum toxin type A used to relieve muscle spasticity in patients who, after a stroke, suffer from increased muscle tone without contracture. Such patients, as a rule, experience muscle spasms accompanied by pain, as well as impaired motor function of the limbs.

The drug Dysport is administered intramuscularly in several injections.

The clinical effect occurs only after some time: from several days to 2 weeks. The improvement lasts up to six months. In this case, the timing of injections is of great importance. Treatment with Dysport a year after a stroke will not lead to the same effect as treatment in the early stages. In this case, mild paresis may persist. Practical studies of Dysport have proven its high effectiveness in the treatment of spasticity of the arm muscles after a stroke.

The components of Dysport may cause allergies. Side effects also include pain at the injection site and minor skin rashes. When Dysport is administered for the first time, general weakness may be observed; with a repeated course of treatment, as a rule, these effects are not observed.

Dysport injections at the Three Sisters center

Only qualified doctors who have experience in diagnosing and treating the drug, as well as those who have undergone appropriate training, can prescribe and carry out treatment with Dysport. Under no circumstances should injections be given by an inexperienced doctor or without prior examination. It is important to know that side effects can be avoided by administering the minimum effective dose of the drug.

At the Three Sisters rehabilitation center, the drug Dysport is used in the treatment of patients undergoing recovery from a stroke. Before prescribing Dysport, patients at the Three Sisters rehabilitation center undergo a full examination using the latest equipment. The center’s specialists have extensive experience in treating with this drug, regularly take specialized training courses in Russia and abroad and know all the nuances of its use.