Muscle hypertonicity in children and adults. Causes and Treatment

Muscular hypertension can be spastic, plastic or mixed. It is provoked by physiological and pathological causes, including trauma, stroke, central nervous system infections, and cerebral palsy.

Muscle hypertonicity is a pathological condition during which all a person’s muscles are in constant tension. In this case, the patient experiences an increase in the resistance of the tissues that form the muscle during passive motor manipulations in one or more joints.

In neurology, muscle dysfunction is divided into 2 types: hypertonicity and hypotonicity (muscle hypotonia). If in the first case the tone of the muscle tissue is increased and they are always in a tense state, then in the second situation everything happens exactly the opposite. However, it is hypertonicity that occurs most often among patients, so it is necessary to know as much as possible about it.

The causes of muscle hypertonicity are divided into 2 groups:

physiological;
pathological.

Each of these types includes certain factors that contribute to the development of pathology. Thus, the physiological causes of hypertension imply the following:

excessive strain on muscles;
overwork;
prolonged sitting in an uncomfortable or unchanged position;
the body's reaction to sudden pain;
bruises and injuries;
severe and regular stress.

Pathological causes of muscle hypertonicity:

previous strokes (ischemic or hemorrhagic in nature);
the presence of tumors in the brain or spinal cord;
vascular pathologies of the brain;
traumatic brain injury;
parkinsonism syndrome (Parkinson's disease);
epileptic seizures;
myopathy;
tetanus;
infectious diseases of the central nervous system (encephalitis, meningitis and others).

Muscle hypertonicity is never asymptomatic, so recognizing it, being aware of the signs of its manifestation, will not be difficult. But it is important to take into account the fact that certain symptoms of pathology depend on its type. These are the ones that need to be addressed in more detail.

Types of muscle hypertonicity and their features

Muscular hypertension can be of two types:

spastic;
plastic.

The spastic type is characterized by a violation of the integrity of the structures of the pyramidal system responsible for performing motor operations different groups skeletal muscles. In this case we're talking about about serious damage to the central neuron of the pyramidal system. In this case, a person develops spastic muscle hypertension. For this type of pathology distinctive feature is that at first the movement is performed with difficulty, but after this the muscle resistance stops on its own, and the person can calmly complete the action. This anomaly is called the “jackknife” effect.

Such a deviation can only be noticed if the movements are performed quickly or even rapidly. Since spastic muscular hypertension affects the motor center of the brain, such an anomaly often affects not one individual muscle, but entire groups of them. For example, you can notice the “jackknife” effect when bending or straightening your elbows, knees, or other parts of the body. This anomaly is quite common among patients who have suffered a stroke, in which a serious disruption of the functioning of the motor centers of the brain occurred.

The plastic type of muscle hypertension is characterized by damage to the extrapyramidal nervous system, which is responsible for maintaining the body in the position adopted by a person, as well as for motor reactions during crying, screaming, laughter and other emotional manifestations. This type of muscle hypertonicity is also called rigid. In this case, muscle tissue tension is present in the patient on an ongoing basis, and not at the beginning of certain motor operations.

Plastic hypertonicity of the muscles is accompanied by the so-called “waxy flexibility”, when a limb or other part of the body freezes in the position that a person gave it.

When performing passive movements, their intermittency is noted. Often, a similar anomaly is observed in people suffering from parkinsonism syndrome.

If neuronal damage occurs in both systems simultaneously, then in this case we are talking about a mixed type of muscle hypertonicity. Patients suffering from this type of muscle hypertension combine symptoms of both spastic and plastic hypertonicity.

Clinical picture of muscle hypertension

Symptoms of muscle hypertonicity are very difficult to miss, whether the patient is an adult or a small child. Characteristic clinical manifestations of the syndrome are the following:

constant muscle tension;
a significant decrease in the mobility of the part of the body where the muscles were affected;
discomfort when performing certain motor manipulations;
feeling of muscle stiffness;
spasms in a single muscle or in entire muscle groups;
performing spontaneous (uncontrolled) motor manipulations;
significant increase in tendon reflexes;
severe inhibition when relaxing muscles that were subject to spasms.

In young patients, in addition to the symptoms described above, with increased muscle tone, sleep can also be severely disturbed and general well-being may deteriorate. They lose their appetite, they become moody and whiny.

The presence of such a pathology in a child can be recognized by one pronounced sign, which is walking on toes. This anomaly can also be observed in an adult who developed hypertension in early childhood.

Having noticed such an alarming symptom, the patient must make an appointment with a neurologist and undergo the necessary diagnostic procedures. Based on the data obtained, the doctor will be able to develop the most effective scheme treatment. It is individual for each patient, so self-medication in this case is strictly contraindicated!

Treatment of muscle hypertonicity in adults and children

After all the necessary medical studies have been carried out (MRI, CBC, EMG), and the diagnosis has been confirmed, the neurologist proceeds to drawing up a treatment regimen. An integrated approach in the following areas plays a huge role here:

elimination of symptoms of muscle hypertonicity;
correction of complications that this syndrome can lead to.

Unfortunately, the root cause of the development of muscle hypertension cannot be eliminated in all patients. Complex treatment of muscle hypertonicity involves the following aspects:

carrying out drug therapy;
massage sessions;
physical therapy exercises;
conducting psychotherapy.

Drug treatment is aimed at relieving spasms and pain in the patient. For this purpose, muscle relaxants, metabolic drugs and antipsychotics, as well as vitamin complexes, are used.

In addition to taking medications, patients are prescribed electrophoresis sessions with relaxants and anticholinergics. This therapy is indicated for patients with a spastic type of muscle hypertonicity.

Physical therapy and massage sessions help restore smooth movements, however, to achieve better results, it is necessary to carry out such therapy at the very beginning of the development of pathology. These two therapeutic methods complement each other perfectly, due to which high results are achieved from their implementation in the treatment regimen.

Massage can be prescribed not only for all muscle groups, but also for individual points on the body. It is used if hypertonicity is not continuous, but local. The points that will be affected are determined by the attending physician individually for each patient.

Sometimes surgical intervention may be prescribed for muscle hypertension, but this is performed only in extremely severe cases. The operation involves the brain or spinal cord, peripheral nerves and muscles.

Psychotherapy is carried out for the complete rehabilitation of the patient after completing the course of basic therapy. Despite the fact that treatment of muscle hypertonicity is a rather lengthy and labor-intensive process, it still gives excellent results. The main thing is that the patient himself is committed to a positive outcome of therapy, and contributes to this in every possible way. Then he will have a much better chance of getting rid of the pathology for a long period of time and improving the quality of his life.

The musculoskeletal system consists of a huge number of muscles that actively contract and provide people with movement. They are very elastic and tensile fibers consisting of muscle tissue. When exposed to nerve impulses, a contraction process occurs. Muscles enable movement of various parts of our body, as well as the expression of emotions.
People perform various movements without problems, from the simplest - winking and smiling - to complex ones. Proper muscle activity ensures not only mobility, but also the normality of all organs and systems, as well as the processes occurring in them. The nervous system regulates the process of functioning of all muscle tissues and is a ligamentous link with the brain and spinal cord, and also takes an active part in the procedure of converting chemical energy into mechanical energy.

Tone

Prolonged work and heavy loads contribute to muscle fatigue. Due to injury, as well as various diseases nervous system The proper functioning of muscle fibers is disrupted and muscle tone occurs.
Muscle tone is the uncontrolled tension of muscle fibers, which results in their contraction while in a relaxed state. The main pathological conditions are:

muscle hypotonicity;

Hypotonicity

Hypotonia is a pathological change in which muscle tone decreases. Often this condition is diagnosed not only in children, but also in adults. As a result of this pathology, muscle fibers weaken and, over time, stop responding to impulses sent by the nervous system.

Symptoms

The main signs that indicate the presence of muscle hypotonia are:

severe muscle weakness;
the occurrence of atony;
decreased physical activity or its complete absence;
problems with the breathing process;
joint deformation;
the person is unable to sit independently, he falls into a lying position.

Kinds

These changes can provoke more than a hundred diseases. As a result, there is a division into the following types:

diffuse;
local;

According to the degree of development of this condition, hypotonicity is divided into the following types:

gradually developing;
spicy.

Classification is also carried out in connection with the causative factors that provoke a decrease in muscle tone:

congenital – develops as a result of genetic abnormalities;
acquired – appears throughout life as a result of various systemic diseases.

Causes

Factors in the occurrence of muscle hypotonicity can be both genetic and other types of diseases. The main ones are:

Down syndrome;
Martin–Bell syndrome;
Rett syndrome;
Canavan disease;
Pituitary dwarfism;
Menkes disease;
dystrophic changes in muscles;
leukodystrophy;
atrophic processes in the spinal muscles;
meningitis;
polio;
sepsis;
myasthenia gravis;
negative reaction to grafting;
celiac disease;
hypervitaminosis;
jaundice;
rickets.

Paralysis

Muscle paralysis is a pathological condition that results in the loss of important muscle functions necessary for motor activity. Muscle tone occurs due to conditions such as:

myopathy;
muscular dystonia;
infectious diseases;
tumor formation and hemorrhages in the brain and spinal cord;
accidents and various injuries.

Paralysis is divided into two types:

flaccid - this is a very strong decrease in the muscular torus, which leads to the death of muscle fibers;
spastic – characterized by excessively increased muscle tone, in which a person is unable to independently control the movements of his body.

In addition to the classification described above, there are certain diseases that are classified as paralysis. The main ones are:

Bell's palsy;
bulbar palsy;
Erb's palsy.

Bell's palsy

As a result of various factors affecting our face, lesions may occur. facial nerve which will lead to his paralysis. The main reasons are:

hypothermia;
malignant neoplasms;
injuries and surgical interventions.

The appearance of the disease brings with it many inconveniences and major changes, which reduce the quality of life and lead to disability. After a few weeks, some muscles lose function and then become completely paralyzed. As a result of such processes, a person cannot speak, eat, or close his eyes completely during sleep. It is extremely rare to experience a state of paralysis of all muscles on both sides of the face.

Bulbar palsy

This type of disease occurs due to damage to the brain stems and is characterized by impaired motor functions of the oral organs, pharynx and larynx. There are problems with speech, swallowing liquids and solid foods. Breathing becomes difficult and suffocation and death can occur.
In medical practice, bulbar palsy is divided into two groups:

spicy;
progressive.

This type of paralysis is extremely rare, but once it occurs, it cannot be completely eliminated. As a result, the patient's life expectancy can be several years.

Erb's palsy

This type very often occurs when a birth injury occurs to the brachial plexus. Damage to the fifth nerve of the spinal cord occurs. Difficult childbirth can result in paralysis of the muscles of the shoulder and forearm. Such cases are rare in newborn babies, but they do happen.
The child becomes restless, muscle tone decreases, problems arise with respiratory system and movements of the injured limb, or rather it is practically absent.

Paresis

Paresis is a condition in which there is a decrease in muscle strength.
The resulting paresis is characterized by the following symptoms:

when walking, a person shifts from one foot to another, like a duck;
motor activity of the limbs becomes difficult;
the head and feet hang down when lifting the leg up;
it is difficult for the patient to stand and sit.

Kinds

Depending on the location, paresis is divided into the following types:

monoparesis – occurs in only one arm or leg;
hemiparesis – one side of the limb is affected;
paraparesis - localized only in both arms or legs;
tetraparesis - location is all limbs.

Causes

Paresis often occurs due to the following factors:

disruption of cerebral and spinal blood flow;
disseminated encephalomyelitis;
abscesses in the brain and spinal cord;
poisoning with various poisons;
myasthenia gravis;
botulism;
epilepsy;
motor neuron diseases (amyotrophic sclerosis).

Diagnostics

To determine the factor that causes an increase or decrease in muscle tone, a number of the following diagnostic methods are carried out in a medical institution:

collecting data about the patient and his entire family;
examination of the affected areas by a specialist and checking for reflexes;
CT scan;
magnetic reflex tomography;
general and biochemical blood test;
genetic studies are carried out for hypotension;
myelography;
nerve conduction studies;
biopsy muscle fiber from the area where changes in muscle tone appear.

To thoroughly study the cause of pathological changes occurring directly at the site of muscle hypotonicity, topical diagnostics are used. During its implementation, a detailed study takes place:

peripheral nerve;
peripheral motor neuron in the spinal cord;
cerebellum.

Diagnosis of paresis, in addition to the above methods, is carried out on a 5-point scale:

5 points - functions are not impaired, there is no paresis;
4 points - slight decrease in muscle strength;
3 points - significant decrease in muscle strength;
2 points - muscle contraction when it is impossible to resist gravity;
1 point - unproductive contraction of individual muscle bundles of the muscle;
0 points - lack of muscle strength.

Based on the results of the diagnostic measures, a correct diagnosis will be made and an effective course of therapy will be prescribed that will help get rid of this condition and restore lost functions.

Therapy

To treat hypotension, medications are used that will help cure the disease that causes muscle weakening.
A massage complex is performed, using active movements to influence weakened muscles. The following techniques are often used during manipulation:

tingling;
rubbing;
kneading;
tingling.

During the procedure, massage specialists apply pressure to special points that will help increase muscle tone.
And also used physiotherapy. Execution of the complex physical exercise help strengthen muscles and get rid of hypotension as quickly as possible.
Therapy for paralysis includes symptomatic treatment, and in parallel with it, therapeutic exercises, massage and medicines. In addition to these measures, it is necessary to place the affected areas of the body in the correct position.
Treatment of paresis, as well as paralysis and hypotonicity, is aimed at eradicating the disease that provokes its occurrence. Thermal procedures are also used in conjunction with massage. As a result of such manipulations, blood flow and tissue trophism improve. The functionality of the affected limbs is restored.

Complications

Muscle hypotension can cause various unpleasant processes in the human body, such as:

metabolic disease;
kit excess weight bodies;
deformation of the spinal column.

A course of therapy for paralysis does not guarantee that all muscle functions will be fully restored. Such people need special care, because they can be completely or partially immobilized for a long period. Staying in the same position for a long time provokes the development of a number of the following problems:

blood pressure increases or decreases greatly;
joint mobility worsens;
metabolic processes are disrupted;
the lungs are not fully functional;
problems of the urinary system;
disruption of the circulatory system;
headaches and dizziness;
fainting.

Such people are recommended to use special compression devices that will help avoid thrombosis, and it is also very important to maintain body hygiene so that bedsores do not occur.
With paresis, a persistent neurological defect occurs, which leads to disturbances in social and labor adaptation.

Prevention

To avoid such changes in muscles, you need to monitor your health and take preventive measures, such as:

complete refusal bad habits(smoking, alcohol);
walks in the open air;
regular doctor's examinations;
getting rid of emerging diseases as quickly as possible.

Video: PARESIS AND PARALYSIS. What is paresis? What is paralysis?

Normal muscle contractility ensures the harmonious physical and mental development of the child. Muscle tone in a baby can be physiological and pathological. Physiological conditions include increased muscle tone in the first weeks after birth. Next, the tone should return to normal. If a child still has increased muscle tone two weeks after birth, this phenomenon is called hypertonicity and belongs to the category of pathological conditions.

Hypertonicity of the muscles of a newborn is an understandable phenomenon. Inside the womb, the child was in a constrained state. His limbs were tightly pressed to his body, there was no room for movement.

After birth, the baby's body gradually gets used to new conditions. During the first two weeks, the muscles gradually relax, and the limbs return to a new state. However, if the baby has central nervous system lesions of varying severity, the brain will not be able to fully control muscle activity. In this case, the condition of the muscles will deviate from normal.

The persistence of hypertonicity during the first month of life should be a reason to examine the child by a neurologist.

Age norms

Considered normal next development situations.

Pathology can be suspected from birth. Problems with the central nervous system are often expressed in muscle hypertonicity syndrome. In such children, all movements are constrained, lower limbs– no more than 45 o. The arms and legs are firmly pressed to the body, and the fingers cannot be unclenched.

What should you be wary of?

Hypertonicity syndrome interferes with the further development of the child, the formation of joints and ligaments is disrupted. Persistence of the condition can lead to impairment of motor skills, motor activity, and the formation of the spine and posture.

If after the first month of life the baby’s muscle hypertonicity persists, in the future he will have the following signs.

The child behaves restlessly, sleeps poorly, wakes up in less than an hour and often cries.
The baby spits up profusely after every meal.
During sleep, the child arches his back and throws his head back. This is a characteristic feature of hypertonicity. At the same time, his arms and legs are bent and pressed to the body.
During a tantrum, the child is tense and bends. In a nervous state, trembling of the chin is noted.
The baby is able to hold his head up vertical position from birth.
When you spread your legs to the sides, you feel strong muscle tension. When you try again, the tension increases. The child resists and protests with a cry.
In an upright position, the baby does not rest his entire foot on the surface, but stands on his toes.

Existing signs of hypertonicity should prompt parents to seek advice from a neurologist.

During the examination, the doctor identifies the presence or absence of certain reflexes in the child and their compliance with the age norm.

Walking reflex. In an upright position, the baby tends to take steps. Normally, this ability disappears after 2 months of age.
Symmetry of reflexes. When lying on the back, the baby's chin is pressed to the chest. At the same time, the behavior of the limbs is observed - bending of the arms and straightening of the legs should occur. When the head is tilted to the right, there is straightening of the limbs on the right side and tension on the left. When you turn your head in the other direction, everything happens exactly the opposite. This reflex should disappear after 3 months.
Ability to tone. While lying on his stomach, the baby should tuck his limbs. Lying on your back relaxes your arms and legs. After three months the ability disappears.
When examining a newborn, the doctor places the baby in his arm, face down. In this position, the baby should experience contraction of the arms and relaxation of the legs. Under normal conditions, the head and back should extend into one line.

Parents can detect symptoms on their own. If a violation is suspected, they should consult a doctor.. A neurologist will be able to determine the presence or absence of a diagnosis and establish its type.

Nature of violations

Muscle tone can be either increased or decreased. Sometimes there is an imbalance - a combination of the first and second. In other words, increased muscle tone in the arms and decreased tone in the lower extremities may be present at the same time, or vice versa. This symptom is called dystonia.

With asymmetry, muscle hypertonicity occurs only on one side. This condition is also called torticollis. The child is placed in a prone position and examined from the back. With asymmetry, the head is turned towards that half of the body where hypertonicity appears. On the same side, there is a bend in the back and tension in the arms.

Hypotension is also considered a disorder. This phenomenon has the opposite symptoms of hypertonicity and manifests itself in lethargy and impaired motor activity.

Muscle hypertonicity and hypotonicity may not appear systemically, but in individual parts of the body. In this case, there is a decrease or increase in muscle tone only in the arms, legs or back.

Violation of muscle tone is not an independent disease, but indicates other, more serious pathologies of the nervous system. That is why the symptoms of hypertension should not be ignored. If the syndrome is detected, the child must be thoroughly examined. In this case, an ultrasound of the brain is performed, and in rare cases, a tomogram.

Possible reasons

The causes of damage to the central nervous system can lie both in problems associated with pregnancy and in complications during childbirth.

Scroll possible reasons lesions of the central nervous system in a child that cause a violation of muscle tone:

infectious diseases of the mother during pregnancy;
improper lifestyle of a pregnant woman;
taking medications by the mother during pregnancy;
Rh conflict between the expectant mother and fetus;
injuries received by the child during childbirth;
genetic incompatibility of parents;
unfavorable environmental situation.

The presence of these factors can only indirectly confirm the presence of a symptom of hypertonicity in a child.

Treatment should be aimed not only at correcting muscular dystonia, but also at identifying and eliminating the underlying cause that caused the condition.

Treatment options

When treating muscle tone disorders, non-drug methods are primarily used:

massage techniques;
water procedures (bathing in herbal infusions of valerian, motherwort, sage, excluding diving);
gymnastic exercises, with the exception of dynamic gymnastics;
physiotherapy;
osteopathic techniques.

When prescribing medications, those that can improve cerebral circulation, improve metabolic processes and reduce muscle tension are selected.

Minor violations may hide serious reasons. Harmonious development the child should extend in all planes. A deviation in one area may lead to a violation in another area. Alarming symptoms of changes in muscle tone should not be ignored. During the examination, the doctor will be able to determine in which direction to move next, what examination and treatment the child may need.

Muscle tone disorders are one of the manifestations of various diseases of the nervous system. The most common problem is hypertension.

Muscle tone is the residual tension of muscles during their relaxation, or resistance to passive movements during voluntary muscle relaxation. In other words, this is the minimum muscle tension that remains in a state of relaxation and rest.

Changes in muscle tone can be caused by diseases and injuries on the different levels nervous system. Depending on the type of disorder, muscle tone may increase or decrease. As a rule, doctors in clinical practice are faced with the problem of increased muscle tone - hypertonicity.

Causes of increased muscle tone

Common causes of increased hypertension are the following types of diseases and disorders:
-vascular diseases of the brain or spinal cord with damage to the central nervous system (stroke);
- diseases of the central nervous system in children (cerebral palsy);
- demyelinating diseases (multiple sclerosis);
- spinal cord or brain injuries.

To a lesser extent, muscle tone is influenced by the mental and emotional state, environmental temperature (cold increases, and heat decreases muscle tone), and the speed of passive movements. The state of muscle tone is assessed by the doctor during the study of passive movements.

Signs of muscle hypertonicity

General signs of muscles with increased tone: tension, tightness, decreased range of motion. In mild cases, hypertonicity causes some discomfort, a feeling of tension and muscle tightness. In these cases, the patient's condition improves after mechanical action (rubbing, massage). With moderate hypertonicity, muscle spasms are observed, which cause severe pain. In the most severe cases of hypertonicity, the muscles become very dense and react painfully to mechanical stress.

The main types of muscle hypertonicity are spasticity and rigidity.

With spasticity, the muscles are stiff, which interferes with normal movements and affects gait and speech. Spasticity may be accompanied painful sensations, involuntary crossing of legs, deformation of muscles and joints, muscle fatigue, slower muscle growth. The most common causes of spasticity are stroke, traumatic brain injury, spinal injury, cerebral palsy, multiple sclerosis, encephalopathy, and meningitis.

Spastic hypertonicity is characterized by uneven distribution, for example, only the flexor muscles spasm.

With rigidity, the tone of skeletal muscles and their resistance to deforming forces sharply increase. Muscle rigidity in diseases of the nervous system, poisoning by certain poisons, or under the influence of hypnosis is manifested by a state of plastic tone - the muscles become waxy, and the limbs can be given any position. Rigidity, unlike spasticity, usually affects all muscles evenly.

To treat muscle hypertonicity in adult patients, muscle relaxants (mydocalm, etc.) are most often used in combination with physiotherapy. In the treatment of local muscle spasms In certain cases, botulinum toxin may be used. To treat some forms of hypertension (for example, muscle stiffness in Parkinson's disease) medications, which affect dopamine receptors.

Muscle tone study It is carried out under conditions of complete muscle relaxation, preferably in a horizontal position of the subject, laid on a hard couch. The tone of the back muscles is determined with the patient lying on his stomach.

To assess muscle tone a method is used to determine the transverse hardness (resistance) of the muscle and the depth of immersion (pressing) of the doctor’s fingers into the muscle. The method is indicative, does not have clear criteria and is tested empirically on a healthy person.

At research transverse hardness of the muscle, the doctor grabs the relaxed muscle with his thumb and forefinger and gently squeezes it, assessing the resistance to compression and the depth of immersion of the fingers. In places where the muscle cannot be grasped, the muscle is pressed against the bone with a finger, and both the resistance and the depth of immersion of the finger into the muscle are also assessed.

In a healthy person engaged in moderate physical labor, the muscles are normotonic. Muscles with high resistance are defined as hypertonic; they are dense and tense. Muscles with low resistance are assessed as hypotonic; they feel flabby and sluggish to the touch. Muscles that have lost resistance are atonic. Deviation from normal tone can be generalized and local.

Another method research muscle tone has the goal of determining contractile tone (tonic resistance), that is, assessing the reflex tension of a muscle caused by its stretching during passive movements in the limbs, torso, and neck.

At study of contractile tone the doctor takes the distal part of the limb, which is in conditions of complete relaxation, and performs passive flexion and extension, while assessing the resistance of the flexor and extensor muscles functionally associated with this joint. The degree of tonic resistance of muscles is also estimated approximately on the basis of clinical experience and skill, as well as comparison of muscle tone in symmetrical parts of the limbs. A decrease or loss of muscle tone occurs due to a violation of the integrity of the reflex arc when a peripheral motor neuron is damaged.

Muscular hypotonia leads to an increase in the volume of passive movements in the joints, a decrease in muscle resistance, and stretching. With muscle atony, these signs are sharply expressed until the joint becomes completely loose. Generalized muscle hypotonia is observed with progressive atrophic lesions muscular system- starvation, dehydration, severe debilitating diseases, generalized form of myopathy, myasthenia gravis. Limited muscle hypotonia (atony) is more often detected on the limbs, in the muscles of the shoulder and pelvic girdle. The causes may be diseases of the central and peripheral nervous system, as well as long-term dysfunction of the joint.

Increased muscle tone observed in cases of damage to the pyramidal and extrapyramidal systems. Muscle hypertonicity is one of the leading symptoms of central paralysis.