METHODS OF PROVING VARIATIONS IN MUSCLE T ONUS

Muscular spasm is a frequent symptom which is difficult to record prec isely. On the basis of literature on the subject and of own studies, w e undertook to describe various methods of examination which could be used to demonstrate such changes. Up to now, palpation is still the mo st important and most exact method for the experienced examiner. In th is way local as well as extended muscular spasms can be made evident. The disadvantage however is the lack of objective proof. The easy-to-u se Tissue-Compliance-Meter of Fischer, which measures the consistency of soft tissue, documents the intraindividual difference rather than t he interindividual difference. This is due to the individually variabl e thickness of the subcutaneous fatty tissue. However, on the whole th ere is a good correlation to the findings of palpation. The pendulous- test and badismography allow especially the conclusion with regard to unilateral changes of tonus in the gluteal and upper leg muscles. This method also very well suits the intraindividual comparison, but less so the interindividual one. The continuous electromyogram is able to s how the enhanced activity in spasmotic muscles also during sleep. The evaluation of enhanced muscle activity remains uncertain when using pl ain electromyogram. Recording of muscle tissue oxygen pressure is of l ittle use to evaluate muscle spasm. Nonetheless, it provides interesti ng insights into pathogenetic questions. Thermography, measuring the b lood circulation at the skin surface, is especially suited for perceiv ing intraindividual differences in case of muscle spasm. Nuclear magne tic resonance spectroscopy allows for noninvasive pH measurements in t he muscle and therewith renders certain data concerning the degree of tension of this tissue. It is not yet suited for routine examination. The value of positron emission tomography for registering muscle spasm remains uncertain. Hopefully, this method, which documents the muscle energy metabolism, will enable us to more clearly evaluate muscle spa sm than previous methods have done. Light and electron microscopic stu dies have provided contradictory results' concerning histological chan ges in muscle biopsy in case of muscle spasm.