The Movement Disorder Society

MDS Abstract of the 16th International Congress of Parkinson's Disease and Movement Disorders, Volume 27,
June 2012 Abstract Supplement

Movement Disorders 2012
Dublin, Ireland June 17-21, 2012.


Ultrasonography for local muscle spasticity management

Bubnov,  R.V.

Objective:

The aim of paper was to assess muscle spasticity structure changes, visible in ultrasound (US) imaging, to suggest acceptable approach is for local release under imaging guidance and guided diagnostic procedures as EMG or biopsy. The patented method of trigger points dry needling under ultrasound guidance was presented.

Background:

US previously has not been spread widely to diagnose muscle spasticity, fibrillations, myopathy ultrasound diagnosis were presented in few papers. We previously reported trigger point dry needling, peripheral neuropathy and local myopathy ultrasound diagnosis. According to our previous experience, ultrasound is most acceptable technique for image guidance and monitoring pain and spasticity treatment.

Methods:

36 patients were recruited, who suffered from local muscle spasticity, that caused movement, postural disorders and pain with different pathology, including hereditary myopathy, Parkinson's disease, rheumatic (dermatomyositis, sclerodermia), peripheral neuropathy, poststroke spasticity and trigger points. US was conducted by using linear 12Mhz probe with sonoelastography function. Patients underwent US guided needle-EMG, biopsy for diagnosis and dry needling for treatment local spasticity.

Results:

In all patients there were registered changes on ultrasonography. Local spasticity of muscle was visualized as areas of violation the normal fibrillar structure of affected muscles, mostly hypoechoic. Sponatneous fibrillation was clearly visualized, specific changes of echogenicity and stiffness of affected areas. Functional tests to identify areas with increased susceptibility to spontaneous contractile activity. Sonoelastography identified areas of decreased elasticity in the muscle. Integrated application of neuromuscular US recognized specific patterns and US guided neurophysiologic study and biopsy allows to recieve additional information. Dry needling was effective for inactivation trigger points (94%) and had short effect in 75% patients with Parkinson's disease.

Conclusions:

Integrated neuromuscular US could be acceptable method for analysis of muscle structure, movement and tonus for evaluation of different kinds pathology of muscles, also in early stages with poor clinical manifestation and allows to perform targeted treatment. Further trials are required to assess specificity for different causes of spasticity.

Keywords :

Myalgia,Myogenic disorders,Needle electromyography,Spasticity: Treatment

To cite this abstract, please use the following information:
Bubnov, R.V.; Ultrasonography for local muscle spasticity management [abstract]. Movement Disorders 2012;27 Suppl 1 :336