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The Treatment of Neuro-muscular Spasm in MS

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Posted 30 July 2005 - 12:41 PM

The Treatment of Neuro-muscular Spasm in Multiple Sclerosis

One of the most common symptoms occurring in MS is neuro-muscular spasm.

This troublesome symptom may be of two types, either tonic or clonic spasm.

Tonic spasm is when the resting muscle tone is abnormally increased. This is often simply apparent as stiffness, when the limb appears rigid and difficult to move despite the absence of absolute paralysis.

Clonic spasm is perhaps the most distressing of the two forms as the affected limb or muscle may jerk violently without warning, causing the individual to lose balance and perhaps fall.

The conventional means of treating these symptoms is with drugs including such as Baclofen (Lioresal), Zanaflex (Tyzanidine), Clonazepam, Neurontin (Gabapentin), or Valium (Diazepam). The main penalties of these drugs include the side-effects of sedation or sometimes extreme muscle weakness. Zanaflex is also quite toxic and can cause liver damage with the sustained use of high doses.

Other methods, utilising nutritional supplements are also available.

Although these are often less reliable and unpredictable and, it must be admitted, sometimes totally ineffective, they are harmless, and may be taken, at the advised doses, without risk or penalty.

Calcium and Magnesium: These minerals are both essential to the normal function of muscles, not only in providing the function of muscle contraction but also in maintaining an appropriate level of muscle tone during periods of relaxation. The occurrence of muscle cramp, due to spasm, is well known to be associated with calcium deficiency.

The normal therapeutic daily dose is, at least, calcium 1000mg and magnesium 500 mg. These are best taken at night because calcium levels tend to fall most significantly during sleep when muscle cramp is most likely to occur.

Gamma amino butyric acid (GABA): is a natural amino acid, which, at therapeutic doses, is able to stimulate the production of growth hormone. Growth hormone is normally produced throughout life and is necessary for any process of regeneration and repair.

When first tested it was anticipated that this would stimulate the regeneration of myelin. This may well be so but so far, the process remains unproved.

Its use however was found, in some, to dramatically reduce the incidence of pain and spasm, thus improving mobility and increasing comfort at rest.

Threonine: an amino acid, which, it is suggested, may reduce spasm in some individuals. The necessary dose is one gramme taken twice daily. Amino acids must be taken on an empty stomach for maximal benefit.

Niacin (Vitamin B3); This vitamin is also found to be effective in some individuals. The necessary dose is 500 mg taken three times daily with food. It must be taken with a daily dose of vitamin B complex to be fully effective.

Vitamin B complex is considered to be an essential routine vitamin for use in the treatment of MS.

Niacin may cause uncomfortable skin flushing in some individuals. A non-flush preparation is however available but is more expensive than the basic vitamin.

Methyl-sulphonyl-methane (MSM): a natural sulphur-containing compound, commonly used in the treatment of arthritis, when it is effective in facilitating the regeneration of joint cartilage and other connective tissues of the body.

In MS, it is suggested to be effective in restoring the integrity of the blood-brain barrier, thus reducing the invasion of CD4 T-cells into the brain and diminishing the process of auto-immune attack.

The substance also appears to be effective in reducing the incidence of muscle spasm. The appropriate dose is one or two grammes each day.

Anthocyanidins: taken in sufficient dosage (approximately 250 mg/ day, or more) these too appear to be helpful in reducing muscle spasm and so restoring mobility (see additional information sheet: ?Anthocyanidins in the Treatment of Multiple Sclerosis?).

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