- spasticity is defined as "a velocity-dependent increase in tonic stretch reflexes;"
- muscle contractions, which can be violent, may also occur, initiated by even slight stimulation;
- severity of spasticity is difficult to measure and can vary from moment to moment;
- works at the brain stem level and spinal level;
- limiting factor is the degree of sedation;
- acts directly on muscle
- 25 mg PO qid, w/ incr 25-50 mg q 3-4 hrs (not to exceed 800 mg)
- side effects include lethargy and headache;
- baclofen (20 mg/day in D.D.), diazepam, & clonidine (0.2-0.4 mg/day)
- works at the level of the spinal cord, and is more effective in lesions of the spinal cord and is less effective is cases of spasticity
resulting from central lesions;
- 80% excreted into the urine;
- start w/ 15 gm qd, w/ 5 gm increases q 3-4 days, not to exceed 80 gm per day
Original Article: Intrathecal Baclofen For Severe Spinal Spasticity.
Management of Spasticity with Neuromuscular Blockade: The Role of Botulinum Toxin from the Orthopaedic Care Textbook