Difference between torsion spasm and spastic cerebral palsy Spastic cerebral palsy is one of the most common types of cerebral palsy, accounting for a high percentage of about 75% of all cerebral palsy cases, and is generally prone to asphyxiation and low-birth-weight infants, with lesions mainly in the pyramidal system of the motor area of the cerebral cortex, which is characterized by hyperreflexia of the extensor reflexes, increased muscle tone, hyperreflexia of the tendon reflexes, ankles clonus positivity, positive Bartholomew’s sign, and limb movement restriction. The upper limbs showed elbow flexion and pronation, elbow and wrist flexion, clenched fist with thumb pronated and clenched in the palm. The movements of the two upper limbs were awkward, stiff and uncoordinated. The two lower limbs are stiff, inwardly retracted in a cross shape, the hip joint is internally rotated, and the ankle joint is plantarflexed. When standing with support. The feet are drooping and turned inward, the toes are on the ground, the soles of the feet are not flat, and a scissor-like gait is observed when walking. Its stride is small, walking on the toes, unable to run. The spasticity is often aggravated by exertion and excitement, and relieved by quiet sleep. Autonomous movements are difficult due to spasticity of the joints. The hemiplegic person has a circular gait, and needs to elevate the pelvis when walking because of the difficulty in flexion due to extension of the affected side. The lower limbs make semicircular rotational movements outward. It is worth noting that torsion spasticity, which like spastic cerebral palsy is also characterized by high muscle tone, is now clinically and easily confused, and must be a cause for alarm. Torsion spasms, also known as dysmorphic dystonia, are a group of extrapyramidal disorders characterized by episodic torsional increases in muscle tone in the trunk or (and) limbs. It is a disease commonly seen in adolescents, and generalized dystonia is its typical manifestation, clinically manifested as violent, involuntary twisting of the neck, limbs, trunk or even the whole body, and hyperextension or hyperextension of the arms and legs, and its twisting action is often very slow and intermittently repeated. Torsion spasms patients with abnormal muscle tone, mainly caused by mental tension, in the case of sleep time relaxation, the body can be shown as normal, usually the body into a soft state. By noting the difference between the two, unnecessary treatment mistakes can be avoided. For torsion spasticity patients can do bilateral carotid artery epiphysiodesis to improve the blood supply and nutrition to the brain to improve the patient’s torsion, hyperactivity, increased muscle tone and other phenomena, and at the same time, also combined with the cooperation of the family, a good rehabilitation, through the clinical guidance of the effect is very good. The most suitable treatment for spastic cerebral palsy patients is FSPR surgery, which makes the muscle tone of spastic muscles as close to normal as possible by comprehensively adjusting the patient’s muscle tone. Muscle spasms in cerebral palsy patients are not limited to a single muscle, but are often manifested as spasms of multiple muscles or muscle groups. FSPR surgery can also achieve the effect of comprehensively adjusting the muscle tone, and it can solve the pain of muscle spasms of the patients in a long term, stable, and complete manner, which provides the prerequisites for the recovery of their motor functions to the maximum extent possible. In addition, FSPR also has the incomparable advantage of other surgeries, which is to selectively block part of the nerve back root fibers without affecting the nerve front root and motor function of the innervated muscle movement. The exact site of surgery can be determined by the patient’s specific condition: surgery in the lumbar spine for lower limb spasticity and in the cervical spine for upper limb spasticity. Torsion spasms, in most cases, begin slowly between the ages of 5 and 15. The first symptom is mostly a mild motor disorder of one side of the lower limbs, the foot is inwardly curved, and the heel can not touch the ground when walking, slow and continuous involuntary torsion movement of the trunk and the proximal limbs is the most serious, which causes anterior convexity of the spine and tilt of the pelvis, involuntary movement involves the cervical and scapular girdle muscles, and there is a slanting of the neck and the muscles of the pharynx and throat muscles, which causes facial muscle spasms and difficulty in getting enough sound, torsion spasm is aggravated when making voluntary movement or mental stress, and it is worse when sleeping, and it can be resolved by surgery of lumbar vertebra. Torsion spasm is aggravated during voluntary movement or nervousness, and disappears completely after sleeping. Muscle tone increases during torsion movement, and becomes normal or decreases after torsion movement stops. Recessive hereditary torsion spasm is mostly progressive, with poor prognosis, and most of them die several years after the onset of the disease; however, some of the patients may not have any progression in a long period of time, or may even be relieved on their own. It is a disease common in adolescents, and generalized dystonia is its typical manifestation. Clinically, it manifests as violent, involuntary torsion of the neck, limbs, trunk, or even the whole body, and hyperextension or hyperflexion of the arms and legs, usually centered on the long axis of the body. Its twisting movements tend to be very slow and repeated intermittently. Normally when we accomplish a movement, one group of muscles contracts while the other corresponding group relaxes. In patients with torsion spasms, this consciously followed program of contraction and relaxation of the muscles is disrupted and replaced by a constant tense contraction of certain muscles, even in a quiet state. Common presentations of the patient are: standing with the head twisted to one side, the shoulders thrown back, one arm stretched forward and one back, both knees bent inward, the feet spread very far apart for balance, or with inversion of the foot, with the soles of the feet unable to land completely on the ground. When lying down, the body will be bowed, relying on the shoulders and hips for support, and some can only lie prone on the bed. Over time, certain muscles may become abnormally hypertrophied and joints may contract and deform. Symptoms disappear when the patient falls asleep. Mildly impaired lower limb movement: the foot is inverted plantar flexion of the lower limb movement is mildly impaired, the heel can not touch the ground when walking, followed by involuntary spasm and twisting of the trunk and limbs, the trunk in a spiral movement. Seizures were accompanied by increased muscle tone, which was normally normal, aggravated by stress, and disappeared during sleep. Muscle strength and sensation are normal. During the attack, the child showed nervousness, fear and sweating all over the body. When the cervical, facial and pharyngeal muscles are involved, cervical strabismus, facial muscle spasm, swallowing and dysarthria may occur. At the beginning of the disease, the seizures are short and the intervals are normal. In the later stages of development, it can cause spinal and pelvic deformities and severe disability due to muscle and joint contractures. Common manifestations of the patient are: head twisted to one side when standing, shoulders and back tilted back, one arm stretched forward and one stretched backward, two knees bent inward, two feet separated to maintain balance, or accompanied by foot inversion, the soles of the feet can not touch the ground completely. When lying down, the body will be bowed, relying on the shoulders and hips for support, and some can only lie prone on the bed. Over time, certain muscles may become abnormally hypertrophied and joints may contract and deform. The symptoms disappear when the patient falls asleep. Diagnosis of “torsion spasm” is mainly due to fetal premature birth, asphyxia, hypoxia, fever and many other reasons and caused by kernel jaundice, jaundice into the blood, to the fetal brain development is incomplete, and triggered by the limbs of the muscle tension increases, the head to the side of the back of the bottom of the twist, the upper limbs to the rear side of the twist, the lower limbs to the outer side of the twist, the change in speech, pronunciation for the ‘guttural’. ‘guttural’ and other phenomena. It is also a group of symptoms of repetitive involuntary movements and abnormal twisting postures caused by uncoordinated, intermittent and sustained contractions of the synergistic and antagonistic muscles of the skeletal muscles of the body. Therefore, it is also called dystonicsyndrome. The main characteristic of spastic cerebral palsy is high muscle tone, which leads to abnormalities in the child’s body. For children with cerebral palsy with high dystonia, the necessary surgical treatment and rehabilitation are performed in order to make it possible for the child to get more physical recovery. 1, upper limb manipulation: (1) peri-shoulder massage method: a hand palm side from the child’s shoulder well (large vertebrae and the midpoint of the line between the peak of the shoulder) shoulder peak to the scapula area, repeated operation for 2 minutes. The main points: friction to drive the muscles, not limited to the epidermis, to force evenly and rhythmically. (2) Hands kneading the ball: both hands fingers slightly flexed, the palms are placed in front of and behind the shoulder joint, rotating and kneading the shoulder, such as the ball in the hands of the kneading, and finally the two hands of the large fishbowl placed in front of and behind the shoulder socket, applying the force of squeezing the shoulder joint. Note: the hands should be coordinated. (3) Rolling and kneading the upper limbs: the rolling method is generally used for the shoulders and back, but through practice, the upper limbs can also be used when the flexor muscles are tense, so that it is easy for the children to open the joints and relax the joints, the biceps brachii and the rostro-humeral muscles. (4) pull and shake the ten fingers: thumb belly and index finger belly folder together, push and pinch the child’s finger joints white on the lower strokes and shake to the end of the finger, according to the order of the thumb to the little finger gradually shake it. (5) Slip joints: move shoulder joints, elbow joints, wrist joints, relax the upper limbs. (6) Upper limb acupoints: Xiaotianxin: (located in the intersection of large and small fish), rubbing and pinching Xiaotianxin 30-50 times to pass the meridians. Waiguan: (2 inches above the transverse line of the wrist bone between the ulna and radius, can be pressed and kneaded. Quchi: (curved elbow right angle, elbow transverse stripe in the middle), the treatment of upper limb joint pain, paralysis, numbness. Laogong: (the center of the palm of the hand, when making a fist, at the head of the middle finger) for numbness of the fingers, palm pain. A nest of wind: (the back of the hand, palm transverse lines in the center of the depression) can be kneaded or pinched, the treatment of blood pain. 2, lower limb manipulation: health care practices in the fist top of the kneading, children with general kneading method can also be used to take the method. (1) take the foot three Yang method: ① with both thumbs and the rest of the four fingers together, focus on the outside of the femur, along the foot three Yang meridian (foot Yangming stomach meridian, foot Shaoyang bile meridian, foot sun bladder meridian) along the meridian to the outside of the ankle. ② and then use both thumbs and the remaining four fingers together on the inside of the femur, the foot three yin meridians (foot Shaoyin kidney meridian, foot syncope yin liver meridian, foot Taiyin spleen meridian), along the meridian to the inner ankle, back and forth a few times. The main points: both hands should be coordinated, even and consistent, the thumb and the remaining four fingers as far apart as possible, in order to increase the range of lifting. (2) Rolling the lower limbs: the rolling method is mainly used for lower limb flexors. (3) Lower limb acupoints: Foot Sanli (3 inches below the eye of the outer knee), which can regulate the meridians. Yanglingquan (flexion of the knee, fibula small head in front of the lower part of the depression) can cure hemiplegia, lower limb numbness, pain contracture. Commission in the middle: (the middle point of the horizontal stripe of the rouge nest) can benefit the waist and open the collaterals, treating lumbar and leg pain. Chengshan: (herringbone-shaped depression at the tip of gastrocnemius junction), quenching wind and relieving pain. Xiexi: (anterior transverse lines of the ankle joint at the midpoint, the two tendons of the depression), can be fixed alarm, kneading and pinching can be. (4) slippery joints: (can be whole knee, foot, hip method) Note that the technique should be gentle. After the guidance of rehabilitation doctors, parents should persist in giving rehabilitation massage to children with cerebral palsy. When the massage is effective, parents should go to the hospital in time to see if the child can be treated surgically.