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Scar tissue on brain, poor leg reflexes, unable to sleep deeply, on baclofen medication. Treatment ?

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Practicing since : 2001
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I have scar tissue on an area in my brain that controls my leg reflexes, I forget exactly what it's called but it's the corticospinal something I believe. My legs get tense and stiff and it worsens if I am thinking hard about something, my neurologist said that's because your thoughts run through the same area of the brain apparently.

If my legs are tense and not completely relaxed before I go to bed then I will get a couple hours of XXXXXXX sleep but when I wake up after a couple hours XXXXXXX sleep I will only get light sleep after. If my thigh muscles are loose enough I can sit down for half an hour and when I stand up my thigh muscles will stretch out and loosen up and then I will feel a XXXXXXX relaxation and tiredness in a part of my brain and I can tell that I will get XXXXXXX sleep again. It's like my XXXXXXX thigh muscles are compressing a nerve or something and it's affecting my brain and preventing it from relaxing and getting XXXXXXX sleep.

Can somebody please try and make sense of this for me? Can anything more be done to relax muscle other than baclofen which I am on but isn't having a big effect?
Posted Tue, 8 May 2012 in Brain and Spine
 
 
Answered by Dr. Shiva Kumar R 3 hours later
Hello and thanks for the query.

Your question is a very good one and I will work on providing you with some good information and recommendations regarding what is going on.

Regarding the scar (gliosis) in the brain near your leg areas can cause problems like stiffness also called as spasticity in the legs due to the damage to the corticospinal tracts which control tone of the muscles. The symptoms varies from tightness in the legs to severe tight spasms which can be painful. When such kind of spasms come in sleep, can cause sleep problems which in turn can lead to fatigue, tiredness and depressed.

It is nothing to do with the compression of the nerve in the thigh muscles. Every thing is related to the scar in the brain which is causing stiffness. Baclofen is a very good medicine for stiffness.

If this is not giving you complete relief can try on other oral medicines like clonazepam, Clonidine, Tizanidine, Tolperisone and Botox.

I am sorry you are dealing with this frustrating concern and I hope you can find yourself in better health soon with the help of your GP and get started on the alternate medications for the problem. If medicines don't help try Botox.

Hope I have answered your query.I will be available for follow up.

I thank you again for the query and hope you find this reply to be helpful and informative. If you have any additional concerns I would be happy to address them.

Bye

Above answer was peer-reviewed by
 
Follow-up: Scar tissue on brain, poor leg reflexes, unable to sleep deeply, on baclofen medication. Treatment ? 13 hours later
Thankyou for your reply.

So why would the XXXXXXX thigh muscles being stiff not allow me to get XXXXXXX sleep? When I wake up and they are stiff I can feel a difference in my brain whereas when they are completely relaxed that same part of my brain feels very relaxed and it feels like I'm going to get XXXXXXX sleep.

 
 
Answered by Dr. Shiva Kumar R 10 hours later
Hi,
Thanks for getting back to me.

The stiffness in the XXXXXXX thigh muscles can hamper the normal movement of the limb and causes pain which disturbs your sleep.

When there is no stiffness you feel relaxed without any pain which brings on sound sleep in you.

So reduce the stiffness by either increasing the dose of existing medicines or change the medicines to relax the XXXXXXX thigh muscles.

Wishing you good health.
Take care. Bye
Above answer was peer-reviewed by
 
Follow-up: Scar tissue on brain, poor leg reflexes, unable to sleep deeply, on baclofen medication. Treatment ? 13 hours later
JUst to be clear, when I asked about the compressed nerve I meant is it possible that when my thigh muscles are tight and maybe they are compressing a nerve which is affecting my sleep. I know my tightness is caused by the scar tissue, but I was asking is the tightness in my thigh muscles possibly compressing a nerve?

 
 
Answered by Dr. Shiva Kumar R 10 hours later
Hi,

Thanks for getting back to me.

Stiffness in the thigh usually never compresses any nerves. This can happen only in compartment syndrome which occurs after injury. So i personally feel it is not happening in you due to stiffness.

Wishing you good health.

Take care.
Above answer was peer-reviewed by
 
Follow-up: Scar tissue on brain, poor leg reflexes, unable to sleep deeply, on baclofen medication. Treatment ? 14 hours later
I am on 60 mg of baclofen right now and my legs are still quite stiff sometimes and I have read that 80 mg is usually the most that is recommended, is there anything else you think would help?
 
 
Answered by Dr. Shiva Kumar R 9 hours later
Hi again,

Regarding the dose of Baclofen there is nothing like recomended dose. It depends on maxium tolerated dose by a person without development of side effects. Other thing is if hiking the dose is not helping you, can add other medicines for added effect. I have already mentioned about the alternatives in my earlier reply. If medicines does not help go for Botox injections.

Take care.

Regards,
Above answer was peer-reviewed by
 
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