Energy requirements of spasticity

Direct measurement of energy expended by spasticity in children with severe spastic quadriparesis is difficult. Insertion of an intrathecal baclofen p ump in a 13-year-old boy with severe spasticity and profound mental retarda tion* resulted in an estimated 30 to 40% decrease in his spasticity. As he had been on a carefully calculated ketogenic diet and fed by gastrostomy, h is precise caloric intake was known. Decrease in spasticity, on the same ca loric intake, led to marked weight gain. Reduction of 100 calories intake r esulted in new weight stability. It was possible therefore, to estimate ind irectly energy used by his spasticity. This 100 calories, representing 34% of calories above his resting energy requirement, corresponded to an indepe ndently estimated 30 to 40% of caloric expenditure of his spasticity. It wa s concluded that when calculation of calories is critical, energy utilizati on by spasticity must be taken into consideration.