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Chapter20
Chronic Spasticity
6
Medical
Professional
09/30/2011

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Term
What is Chronic Spasticity?

Possible symptoms
Definition
Increase muscle tone, usually resulting from brain or spinal cord injury

Possible symptoms: impaired feeding, dressing, bower/bladder function, reduction in joint movement, significant PAIN, skin breakdown
Term
When should chronic spasticity NOT be treated? Why?
Definition
DO NOT treat unless it interferes with function or results in pain, as it can unmask limb weakness, and worsen ambulation
Term
Treatment for chronic spasticity
Definition
First line: Baclofen or Tizanidine

Second line: Baclofen + Tizanidine

Third line: Switch to Gabapentin

Fourth line, or earlier if spasticity is of cerebral origin: Botinum toxin or phenol injection, or intrathecal baclofen
Term
Side effects of Baclofen
Definition
Sedation, weakness, lowered seizure threshold
Term
Side effects of Tizanidine
Definition
Dry mouth, sedation, hallucinations, hepatotoxicity
Term
What can be used to treat spasms at night?

Why limit them to at night?
Definition
BDZs eg clonazepam or diazepam

Limit to night time due to sedative effect
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