Botulinum Toxin in Spasticity Management

Česká verzia

Authors: E. Ehler ¹; I. Štětkářová ²
Authors place of work: Ne urologická klinika, Pardubická krajská nemocnice, a. s., 2Neurologické oddělení Nemocnice Na Homolce, Praha ¹
Published in the journal: Cesk Slov Neurol N 2009; 72/105(4): 317-321
Category: Review Article

Summary

Spasticity is characterized by a velocity- dependent incre ase in muscle tone. Spasticity can be divided into three gro ups according to the level of affecti on: generalized, multifocal, and focal. Two different types of spasticity can be discerned according to localizati on of the lesi on: 1) spasticity of cerebral origin (mostly developing after stroke); and 2) spasticity of spinal origin (typically in multiple sclerosis, spinal cord injury, degenerative disorder of the spinal canal). Physical therapy is used in all spastic pati ents. In pati ents with uncontrolled intractable spasticity, after common physical therapy it is important to discuss new possibiliti es of spasticity management. In pati ents with generalized spasticity, myorelaxati on is used in the first place. In pati ents with focal or multifocal spasticity, botulinum toxin administrati on into spastic muscle is recommended. Botulinum toxin injecti on in superfici ally located large muscles is a relatively simple technique, however, infiltrati on to deeply located muscles is recommended thro ugh EMG guidance or stimulati on of the muscle itself by hollow EMG electrode. Currently, two types of botulinum toxin and three commerci al products for spasticity tre atment are available.

Key words:
spasticity – baclofen – botulinum toxin

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