Espasticidad, conceptos fisiológicos y fisiopatológicos aplicados a la clínica

Objective: Spasticity is one of the signs described since centuries ago. Nevertheless, this definition per se would be difficult to understand, inclusive for the neurologist, neurosurgeon and therapist. This review pretends to analyze the meaning and clarify the vision of what does it stand for in clinical practice, to differentiate between one patient with spasticity from one that does not. Development: Spasticity is a secondary disease to an insult of the central nervous system. It is defined as an augmentation of muscular stretch reflex that depends of the muscular movement for its manifestation. Pathogenic mechanisms involved in this disorder include an increased neuronal excitation and a decreased neuronal inhibition, that bring as consequence, hyperreflexia and/or hypertonic muscular reflex. Conclusions: Spasticity is the result of the effect of different events occurring in the central nervous system, including trauma, demyelinizant diseases, tumors, etc. Main damage is caused to the pyramidal tract, but is not clear the role of others anatomical pathways, causing hypertonic and hyperreflectic signs as consequence, being these not evident in other nosological entities.