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A to Z of MS Spasms

Spasms are sudden involuntary contractions of muscles that can make arms, legs or body move in different ways. Also known as paroxysmal symptoms, they can be very frightening. Spasms can be painful or cause numbness, but are manageable and treatable.

Most MS spasms arise in either:

  • legs
  • arms
  • throat muscles (less common)

Leg and arm spasms are often worsened by bladder and bowel problems and infections, so it is worth investigating these if spasms start for no reason or become worse suddenly.

Treatment

Leg and arm spasms benefit significantly from physiotherapy and regular stretching.

The following drugs may be used in addition to this:

  • The NICE Guideline states that the following should only be given if treatment with baclofen or gabapentin is unsuccessful or side effects are unmanageable:

    • Tizanidine
    • Diazepam can be used on its own or in combination with other drugs. It can be taken prior to sleep if spasms are particularly troublesome at night. Side effects can include drowsiness and dizziness.
    • Dantrolene is the only antispasmodic drug that works directly on the muscles rather than on the central nervous system. It can be used in combination with other drugs. Often it is not well tolerated and can cause nausea, vomiting, diarrhoea and weakness. Regular blood tests need to be completed to ensure no adverse effect on liver function.

    Spasms of the throat muscles can cause problems with speech - a sudden fit of slurring, for example - and sometimes with swallowing, often seen as sudden coughing and choking. Treatment may involve a speech and language therapist.

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