PHYS THER
Vol. 84, No. 10, October 2004, pp. 973-981
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Pharmacologic Management of Spasticity Following Stroke

Joann E Gallichio

JE Gallichio, PT, MPT, is Senior Physical Therapist, Montefiore Medical Center-The Jack D Weiler Hospital of the Albert Einstein College of Medicine, 1825 Eastchester Rd, Bronx, NY 10461 (USA) (gallich33@aol.com)


Key Words: Drugs • Spasticity • Stroke

Because this article has no abstract, we have provided an extract of the full text and any section headings.


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Introduction
 
Spasticity is a pervasive and debilitating condition that frequently occurs following upper motor neuron (UMN) lesions. Although the exact incidence of spasticity is unknown, it is likely that it affects more than half a million people in the United States alone, and more than 12 million people worldwide.1 Following stroke, approximately 65% of individuals develop spasticity.2

The definition of spasticity is variable among health care professionals. To some, spasticity simply refers to a velocity-dependent resistance to movement. For others, spasticity is part of a central motor neuron syndrome that includes hyperactive deep tendon reflexes, increased resistance to passive movement, flexed posturing of the upper extremity and extension of the lower extremity, excessive contraction of antagonist muscles, and synergistic movement patterns.3 In 1980, Lance published this frequently cited definition: "Spasticity is a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from . . . [Full Text of this Article]


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General Pharmacologic Principles
 

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Oral Drug Therapy
 
Diazepam

Dantrolene Sodium

Oral Baclofen

Tizanidine Hydrochloride


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Intrathecal Drug Therapy
 
Intrathecal Baclofen

Other Intrathecal Drugs


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Focal Treatment
 
Chemical Neurolytics

Phenol Injections

Botulinum Toxin


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Conclusion
 

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