Nelson Pediatric Symptom-Based Diagnosis: Common Diseases and their Mimics (Second Edition) - Chapter 38: Hypertonicity

Hypertonia describes abnormally increased muscle tone caused by upper motor neuron pathology in the brain or spinal cord. Clinically, hypertonia can manifest in either spasticity, dystonia, rigidity, or a combination of these subtypes. In most cases, hypertonia reflects a static pathologic process, but rarely it can be a sign of a progressive neurologic disorder. Multiple scoring systems exist to evaluate patients with hypertonia. The most common and recognizable childhood disease that manifests with hypertonia is spastic cerebral palsy. Hypertonia management is dependent on the pathology and functionality of the individual patient and includes physical therapy, oral medications, intramuscular injections, and surgical procedures. This chapter discusses the definition of hypertonia, its different clinical subtypes, clinical examination findings, scaling systems, pathophysiology, and finally the different treatment modalities.