Neurol. praxi. 2009;10(3):148-152

Treatment of spasticity in chronic spinal cord injury

doc. MUDr. Ivana Štětkářová CSc

Neurologické oddělení Nemocnice Na Homolce, Praha

Severe spasticity and painfull muscle spasms worsen quality of life, mobility and self-care in patients suffered form chronic spinal cord

injury. Poorly managed spasticity leads to serious long-term complications such as pressure sores, chronic pain, infections and fixed

muscle contractures. Ashworth scale of muscle hypertonia, frequency of muscle spasms and visual analogue scales are the most common

ones used in clinical practice for evaluation of spasticity. The most common treatment of spasticity is oral drug therapy (benzodiazepines,

tizanidine, and baclofen). A local administration of botulinum toxin is suitable for focal spasticity in a small muscle group. In severe flexed

spasticity, ablation procedures may be performed, such as selective peripheral neurotomy, lateral longitudinal myelotomy and posterior

rhizotomy. Physical treatment is also very important. In severe generalized spasticity a long-term treatment often needs higher oral

doses of drugs or various drug combinations, which leads to exaggeration of general adverse effects. Intrathecal continuous baclofen

administration could resolve this problem. Management of spasticity is a long-term process and it needs multidisciplinary approach to

achieve the real treatment goal for each patient.

Keywords: spasticity, spinal cord injury, pharmacotherapy, botulinum toxin, intrathecal baclofen.

Published: July 1, 2009  Show citation