Muscle spasm

Other Calcium Disorders. In addition to hypocalcemia, tremors, osteoporosis, and muscle spasms (tetary), calcium deficiency can lead to rickets, osteomalacia, and possibly heart disease. These, as well as Paget s disease, can also result from faulty utilization of calcium. Calcium excess can lead to excess secretion of calcitonin, possible calcification of soft tissues, and kidney stones when combined with magnesium deficiency. 

Health Hazards Information - Recommended Personal Protective Equipment Goggles or face shield dust mask Symptoms Following Exposure Inhalation of dust may causes irritation of nose and throat. Contact with eyes or skin causes irritation. Ingestion has been observed to cause tremors and muscle spasms in test animals General Treatment for Exposure INHALATION move to fresh air. EYES flush with water for at least 15 min. SKIN flush with water wash with soap and water. INGESTION get medical attention Toxicity by Inhalation (Thresholdlimit Value) Data not available Short-Term Inhalation limits Data not available Toxicity by Ingestion Grade 2 oral LDjq = 3,800 mg/kg (rat) Late Toxicity Causes cancer in rats Vapor (Gas) Irritant Characteristics Data not available liquid or Solid Irritant Characteristics Data not available Odor Threshold Not pertinent. 

Botulinum neurotoxins are widely used as therapeutic agents to cause reduction or paralysis of skeletal muscle contraction. They are used to treat cervical dystonia, which causes regional involuntary muscle spasms often associated with pain. Moreover, they are used in strabism, blepharospasm, hemifacial spasm, and... 

Muscle spasm, fever, nausea, vomiting, kicking movements, weakness, depression, body aches, weight loss, severe backache, abdominal and leg pains, hot and cold flashes, insomnia, repetitive sneezing, increased blood pressure, respiratory rate, and heart rate... 

The mode of action of many skeletal muscle relaxants, for example carisoprodol (Soma), baclofen (Lioresal), and chlorzoxazone (Paraflex), is not clearly understood. Many of tiiese dragp do not directly relax skeletal muscles, but dieir ability to relieve acute painful musculoskeletal conditions may be due to their sedative action. Cyclobenzaprine (Flexeril) appears to have an effect on muscle tone, tiius reducing muscle spasm. 

The exact mode of action of diazepam (Valium), an antianxiety drug (see Chap. 30), in die relief of painful musculoskeletal conditions is unknown. The drug does have a sedative action, which may account for some of its ability to relieve muscle spasm and pain. 

The skeletal muscle relaxants are contraindicated in patients with known hypersensitivity. Baclofen is contraindicated in skeletal muscle spasms caused by rheumatic disorders. Carisoprodol is contraindicated in patients with a known hypersensitivity to meprobamate. Cyclobenzaprine is contraindicated in patients with a recent myocardial infarction, cardiac conduction disorders, and hyperthyroidism, hi addition, cyclobenzaprine is contraindicated within 14 days of the administration of a monoamine oxidase inhibitor. Oral dantrolene is contraindicated in patients with active hepatic disease and muscle spasm caused by rheumatic disorders and during lactation. See Chapter 30 for information on diazepam. 

Immediately report the occurrence of the following adverse reactions restlessness, inability to sit still, muscle spasms, masklike expression, rigidity, tremors, drooling, or involuntary rhythmic movements of the mouth, face, or extremities. Inform all patients about the risks of extrapyramidal symptoms and tardive dyskinesia Avoid exposure to the sun. If exposure is unavoidable, wear sunblock, keep arms and legs covered, and wear a sun hat. 

Masseter muscle spasm, which sometimes is a warning sign of MH, was found in 1 12,000 anesthetics. However, masseter muscle spasm is not diagnostic of an impending MH crisis. Even though approximately 50% of patients with masseter muscle spasm have tested positive for MH by muscle biopsy, this does not reflect the true incidence of MH. Incidence of masseter spasm is reported to be as high as 1% in pediatric patients, yet MH occurs in only about one in 15,000 pediatric patients. 

Dantrolene is the mainstay of MH treatment. It has long been available for the treatment of muscle spasm in cerebral palsy and similar diseases. It is a hydantoin derivative that was first synthesized in 1967, and reported to be effective in the treatment of porcine MH in 1975. Also in 1975, dantrolene was shown to be more effective than procainamide in the treatment of human MH, which until that time was the drug of choice. However, the intravenous preparation was not made available until November 1979. It significantly lowered mortality. The half-life of dantrolene is estimated to be 6-8 hr. Dantrolene s primary mode of action is the reduction in calcium release by the sarcoplasmic reticulum. Dantrolene also exerts a primary antiarrhythmic effect by increasing atrial and ventricular refractory periods. Side effects of dentrolene include hepatotoxicity, muscle weakness, ataxia, blurred vision, slurred speech, nausea, and vomiting. Dantrolene is not contraindicated in pregnancy, but it does cross into breast milk and its effect on the neonate is unknown. 

Tremor Increased blood pressure Mood lability Depression Muscle spasms Weakness Bone pain... 

Beagle) Ix/d (F) and optical stimuli muscle spasms in extremeties, face, and jaw placing and righting reflexes absent) Technical... 

Control muscle spasm associated with tetanus... 

Application of heat or cold treatments to involved joints improves range of motion, reduces pain, and decreases muscle spasms. Practical applications of heat therapy include warm baths or warm water soaks. Heating pads should be used with caution, especially in the elderly, and patients must be warned of the potential for burns if used inappropriately. 

Where pain is worsened by muscle spasm, oral muscle relaxants may serve as a useful adjunct to therapy.25 These agents include baclofen, metaxalone, methocarbamol, carisoprodol, and cyclobenzaprine. Muscle relaxants may decrease spasm and stiffness associated with either acute or chronic musculoskeletal disorders. These agents should be used with caution because they all may cause sedation, especially in combination with alcohol or narcotic analgesics. 

Altered release. Tetanus is an infectious disease caused by the bacterium Clostridium tetani. This bacterium produces a neurotoxin active on inhibitory synapses in the spinal cord. Motor neurons, which supply skeletal muscle and cause contraction, have cell bodies that lie in the spinal cord. Under normal circumstances, these motor neurons receive excitatory and inhibitory inputs from various sources. The balance of these inputs results in the appropriate degree of muscle tone or muscle contraction. Tetanus toxin prevents the release of gamma amino butyric acid (GABA), an important neurotransmitter active at these inhibitory synapses. Eliminating inhibitory inputs results in unchecked or unmodulated excitatory input to the motor neurons. The resulting uncontrolled muscle spasms initially occur in the muscles of the jaw, giving rise to the expression lockjaw. The muscle spasms eventually... 

Describe the mechanisms by which tissue ischemia and muscle spasm lead to pain... 

Muscle spasm. The pain induced by muscle spasm results partially from the direct effect of tissue distortion on mechanical nociceptors. Muscle spasm also causes tissue ischemia. The increased muscle tension compresses blood vessels and decreases blood flow. Furthermore, the increased rate of metabolism associated with the spasm exacerbates the ischemia. As discussed earlier, ischemia leads to stimulation of polymodal nociceptors. 

Petro DJ (1980). Marihuana as a therapeutic agent for muscle spasm or spasticity. Psycho-somatics, 21, 81-85. 

CDC Case Definition Acute onset of hypertonia and/or painful muscular contractions (usually of the muscles of the jaw and neck) and generalized muscle spasms without other apparent medical cause. 

Tetany is the hallmark sign of acute hypocalcemia, which manifests as paresthesias around the mouth and in the extremities muscle spasms and cramps carpopedal spasms and, rarely, laryngospasm and bronchospasm. 

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