I've been thinking about muscle tone a lot lately, since my youngest daughter was dx with hypotonia (and maybe mild CP). She gets tired very easily with walking and physical movement, and has very little stamina for exercises that use her "floppy" muscles.
I know the underlying cause is different, but I was wondering if hypotonia can be a part of MS. I have heard a lot about spasticity in MS, but not the opposite. It seems to me that low muscle tone could contribute (cause?) a lot of the sx that many of us experience: difficulty walking long distances, tiring easily, general feeling of severe fatigue with every day activities. Maybe this has been brought up other places, but I haven't seen a discussion of it. Is this something anyone has heard from their doctors?
Part of the reason I was thinking about it too, is that the treatment for hypotonia in CP (again a different cause than MS, but still a CNS problem) is physical therapy to maximize the tone that's there.
So is hypotonia a possible MS sx (instead or in addition to spasticity)? If so, does anyone here experience it? If so, do you get PT for it and does it help?
Hypotonia is very uncommon in MS. During a simple search I could not find it mentioned in association with MS except in the side effects of some of the muscle relaxants - especially Baclofen.
The mechanism for causing the diffuse hypotonia of CP is diffuse brain damage and not the sporadic, damage of MS. In MS the change in muscle tone is almost always lesions in the spinal cord leading to hyperreflexia, hypertonicity and spasticity. In MS the early fatigue we feel is a function of demyelinated motor nerves that lead to early exhaustion.
Rather than trying to ramp up and use a muscle from floppy to active - which requires a great deal of effort, we suffer from another problem altogether, though the outcome is the same. We tell a muscle to contract, but it doesn't get the full nerve signal to do it. This is specific muscle weakness. Also, if spasticity is part of the problem when wh try to work one set of muscles it's action may be countered by the pull of the opposing spastic set of muscles.
Physical therapy has different goals in MS. We work to maintain what strength we can, and increase what strength we can. We also learn adaptive maneuvers to compensate for the muscles that are not behaving. Another important task of PT is to learn to stretch out spastic muscles properly and frequently. In MS we tend to be stiff and tired and become less flexible.
They have identified many reasons why we become fatigued in MS, but hypotonia is not one of them. Her is a short discussion of these causes of fatigue:
Thanks, Quix. As usual, your explanation was informative! Could you explain why damage in MS only causes spasticity? I guess I was thinking of reflexes as a comparison--they can be hyper-reflexive or hypo-reflexive (right?). Why does motor damage in MS only cause "hypertonia"?
This is all out of curiosity, I just like understanding these things. :-)
not sure i read this clearly, is it your daughter or you who are hyppotonic?
i have not heard of this in ms either.
i am not sure where my disscussion is on the forum here or i forget when it was.
but i am hypotonic. I do have a dual diagnoiss , besides ms i have a type Cerebellar Ataxiaa. it is my understtanding my hypotonia comes from my strophy of my cerebellum shrinking (which happens from the CA). I am not weak persay, but floppy lilmbs and hard to keep my trunk straight and times i am tired my head up. I have never been hypertonic.
I have trieed alot of p.t., which has not improved. It pretty much put me in bed.
I did ask about this here, and only one person said they ever knew children to be hypotonic.
taake care, amo
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