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Spasticity management

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https://www.readbyqxmd.com/read/29339776/the-experience-of-spasticity-after-spinal-cord-injury-perceived-characteristics-and-impact-on-daily-life
#1
William Barry McKay, William Mark Sweatman, Edelle C Field-Fote
STUDY DESIGN: Cross-sectional survey. OBJECTIVES: Determine the impact of motor control characteristics attributed to spasticity, such as spasms, stiffness, and clonus on the daily life of people with spinal cord injury (SCI). SETTING: Nationwide, United States. METHODS: Internet-administered questionnaire, the Patient Reported Impact of Spasticity Measure (PRISM) and items describing characteristics of spasticity including stiffness, spasms, clonus, and pain...
January 16, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29326296/intrathecal-baclofen-therapy-versus-conventional-medical-management-for-severe-poststroke-spasticity-results-from-a-multicentre-randomised-controlled-open-label-trial-sisters
#2
Michael Creamer, Geoffrey Cloud, Peter Kossmehl, Michael Yochelson, Gerard E Francisco, Anthony B Ward, Jörg Wissel, Mauro Zampolini, Abdallah Abouihia, Nathalie Berthuy, Alessandra Calabrese, Meghann Loven, Leopold Saltuari
BACKGROUND: Intrathecal baclofen (ITB) is a treatment option for patients with severe poststroke spasticity (PSS) who have not reached their therapy goal with other interventions. METHODS: 'Spasticity In Stroke-Randomised Study' (SISTERS) was a randomised, controlled, open-label, multicentre phase IV study to evaluate the efficacy and safety of ITB therapy versus conventional medical management (CMM) with oral antispastic medications for treatment of PSS. Patients with chronic stroke with spasticity in ≥2 extremities and an Ashworth Scale (AS) score ≥3 in at least two affected muscle groups in the lower extremities (LE) were randomised (1:1) to ITB or CMM...
January 11, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/29301539/development-of-an-inventory-of-goals-using-the-international-classification-of-functioning-disability-and-health-in-a-population-of-non-ambulatory-children-and-adolescents-with-cerebral-palsy-treated-with-botulinum-toxin-a
#3
Linda Nguyen, Ronit Mesterman, Jan Willem Gorter
BACKGROUND: In the management of hypertonicity in children with cerebral palsy (CP), goals should be clearly identified in order to evaluate the effectiveness of botulinum toxin A (BoNT-A) treatment, specifically in non-ambulatory children and adolescents, Gross Motor Function Classification System (GMFCS), level IV or V. A retrospective chart review (Mesterman et al., 2013) identified the need for the development of a set of specific and meaningful goals linked to the International Classification of Functioning, Disability and Health (ICF) for future goal setting and evaluation in this population...
January 4, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29289915/-congenital-anomalies-of-craniovertebral-junction-presenting-after-50-years-of-age-an-oxymoron-or-an-unusual-variation
#4
Pravin Salunke, Madhivanan Karthigeyan, Narasimhaiah Sunil, Vasundhara Rangan
OBJECTIVES: Manifestation of congenital anomalies of cranio-vertebral junction (CVJ) in the later half of life is unusual and intriguing. Coexisting cervical spondylotic changes with multilevel compression, poorer bone quality as well as less smooth post-surgical recuperation make management of elderly Congenital Atlantoaxial Dislocation/ Basilar Invagination (CAAD/BI) challenging. The clinico-radiological presentation, pathogenesis and outcome are analysed here. PATIENTS AND METHODS: Clinico-radiological data of 20 patients of CAAD/BI (with markers of congenital anomalies) presenting after 50 years of age, the challenges faced and outcomes after C1-C2 fusion have been analysed...
December 21, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29288631/gait-disorders
#5
REVIEW
Jessica M Baker
Walking is an extraordinarily complex task requiring integration of the entire nervous system, making gait susceptible to a variety of underlying neurological abnormalities. Gait disorders are particularly prevalent in the elderly and increase fall risk. In this review, we discuss an approach to the examination of gait, and highlight key features of common gait disorders and their underlying causes. We review gaits due to lesions of motor systems (spasticity and neuromuscular weakness), the cerebellum and sensory systems (ataxia), parkinsonism, and frontal lobes and discuss the remarkably diverse phenomenology of functional (psychogenic) gait disorders...
December 27, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/29284225/correlation-between-the-single-high-dose-of-ingested-baclofen-and-clinical-symptoms
#6
Jacek Sein Anand, Maciej Zając, Wojciech Waldman, Andrzej Wojtyła, Przemysław Biliński, Barbara Jaworska-Łuczak
INTRODUCTION AND OBJECTIVES: Baclofen is a drug used mainly to treat muscle spasticity. Its overdose can lead to life-threatening clinical symptoms, including acute respiratory failure requiring mechanical ventilation. The aim of this study was to assess the prevalence of selected clinical symptoms associated with baclofen poisoning comparing to an ingested dose. MATERIAL AND METHODS: 60 cases of oral baclofen poisoning were analyzed. Gender, age distribution, and correlation between the dose of ingested baclofen were studied, as well as and following clinical parameters: degree of altered consciousness, heart rate, blood pressure, presence of acute respiratory failure, duration of mechanical ventilation, and presence of psychotic symptoms...
December 23, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/29273448/-pain-in-children-with-neurological-impairment-a-review-from-the-french-pediatric-neurology-society
#7
J Avez-Couturier, S Joriot, S Peudenier, D Juzeau
Management of pain is one of the major expectations of children with neurological impairment and their families. The medical literature is poor on this topic accounting for approximately 0.15 % of the publications on pain in general. The objective of the French Pediatric Neurology Society was to review the current knowledge on this topic. Bibliographic research was conducted with PubMed and RefDoc for publications between 1994 and 2014 in French or English. A total of 925 articles were retrieved and 92 were selected for review...
December 19, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29241713/effects-of-superficial-heating-and-insulation-on-walking-speed-in-people-with-hereditary-and-spontaneous-spastic-paraparesis-a-randomised-crossover-study
#8
Amanda L Denton, Alan D Hough, Jennifer A Freeman, Jonathan F Marsden
OBJECTIVES: Cooling of the lower limb in people with Hereditary and Spontaneous Spastic Paraparesis (pwHSSP) has been shown to affect walking speed and neuromuscular impairments. The investigation of practical strategies, which may help to alleviate these problems is important. The potential of superficial heat to improve walking speed has not been explored in pwHSSP. Primary objective was to explore whether the application of superficial heat (hot packs) to lower limbs in pwHSSP improves walking speed...
December 11, 2017: Annals of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29232836/spasticity-management-in-disorders-of-consciousness
#9
REVIEW
Géraldine Martens, Steven Laureys, Aurore Thibaut
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage...
December 9, 2017: Brain Sciences
https://www.readbyqxmd.com/read/29231090/esophageal-dysmotility-in-patients-following-total-laryngectomy
#10
Teng Zhang, Julia Maclean, Michal Szczesniak, Paul P Bertrand, Harry Quon, Raymond K Tsang, Peter I Wu, Peter Graham, Ian J Cook
Objectives Dysphagia is common in total laryngectomees, with some symptoms suggesting esophageal dysmotility. Tracheoesophageal (TE) phonation requires effective esophagopharyngeal air passage. Hence, esophageal dysmotility may affect deglutition or TE phonation. This study aimed to determine (1) the characteristics of esophageal dysmotility in laryngectomees, (2) whether clinical history is sensitive in detecting esophageal dysmotility, and (3) the relationship between esophageal dysmotility and TE prosthesis dysfunction...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29218232/the-role-of-neurectomy-in-the-management-of-spasticity-of-the-upper-limb
#11
Petros Mikalef, Dominic Power
Neurectomy is one of the treatments available to the surgeon treating patients with spasticity of the upper limb.Its popularity has increased in recent years.Accurate knowledge of the anatomical variations of the terminal branches to the muscles is required in order to achieve a successful outcome.Although the anatomy has been thoroughly studied, there are still controversies regarding the percentage of the nerve to be resected for a successful result, and also regarding the terminology that has been used in the literature to describe the procedure...
November 2017: EFORT Open Reviews
https://www.readbyqxmd.com/read/29207797/audit-of-organic-acidurias-from-a-single-centre-clinical-and-metabolic-profile-at-presentation-with-long-term-outcome
#12
Seema Pavaman Sindgikar, Krithika Damodar Shenoy, Nutan Kamath, Rathika Shenoy
Introduction: Organic Acidurias (OA) accounts between 10% and 40% of confirmed Inborn Errors of Metabolism (IEM) in India. With prompt recognition and management, better survival but adverse neurodevelopmental outcome is reported. Aim: To study the clinical and metabolic presentation, management with immediate and long term outcome of symptomatic children with confirmed OA. Materials and Methods: Hospital based study of symptomatic children diagnosed to have OA between 2003 and 2009 and the survivors followed up over next five years...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29205982/spasticity-or-periodic-limb-movements
#13
Jonathan Levy, Sarah Hartley, Elsa Mauruc-Soubirac, Antoine Leotard, Frederic Lofaso, Maria-Antonia Quera-Salva, Djamel Bensmail
BACKGROUND: Spasticity and spasms are distressing features of the upper motor neuron syndrome (UMNS) following spinal cord injuries (SCI) or multiple sclerosis (MS), and have common therapeutic implications. Despite an increase of antispastic drugs and strategies, sometimes up to the surgical implant of intrathecal baclofen pump, some patients still complain of disabling spasms, which poses diagnostic and therapeutic challenges. Although clinically similar, flexor spasms due to pyramidal tract disruption must be clearly differentiated from periodic limb movements (PLM), often accompanying restless leg syndrome (RLS) and occurring during sleep...
December 4, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/29200489/flexion-deformities-of-the-wrist-and-fingers-in-spastic-cerebral-palsy-a-protocol-of-management
#14
Tarek Hassan Abdelaziz, Shady Samir Elbeshry, Mahmoud Mahran, Ahmad Saeed Aly
Background: Literature is confusing regarding grading and treatment of flexion deformities of wrist and fingers in spastic cerebral palsy (CP). The most established classification is that described by Zancolli; unfortunately, it has its shortcomings which we experienced in the beginning of our approach to manage this rather difficult deformity. We thus modified Zancolli's classification and developed a classification system and treatment protocol. Materials and Methods: Thirty patients with spastic CP were operated upon due to flexion deformity of the wrist and fingers and were included in this study...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29192135/encephalocraniocutaneous-lipomatosis-haberland-syndrome
#15
Selçuk Özdoğan, Ceyhun Saymaz, Cumhur Kaan Yaltırık, Hanife Gülden Düzkalır, Mustafa Kaya, Nail Demirel, Ali Haluk Düzkalır, Başar Sarıkaya, Berrin Aktekin
BACKGROUND Encephalocraniocutaneous lipomatosis (ECCL) was first announced as a new type of ectomesodermal dysgenesis in 1970 by Haberland and Perou. ECCL was first described in 1970, and approximately 60 cases have been reported since then. The classic triad of ECCL are skin, ocular, and central nervous system involvement, including conditions such as unilateral porencephalic cyst, ipsilateral lipomatous hamartoma of the scalp-eyelids-eye globe, cortical atrophy, cranial asymmetry, developmental delay, seizures, mental retardation, and spasticity of the contralateral limbs...
December 1, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29184718/three-consecutive-neurotomies-in-one-patient-for-the-treatment-of-spastic-hemiplegia-spinal-median-and-foot-toes-common-flexor
#16
José D Carrillo-Ruiz, Pablo Andrade, Mary Fonseca, Fiacro Jiménez, María L Montes-Castillo, Francisco Velasco
Background: Neurotomies were one of the first procedures performed in the field of functional neurosurgery. Microstimulators and microscopes facilitate the performance of neurotomies to treat focal spasticity. This report shows how three different consecutive neurotomies were performed in one patient with chronic left upper/lower extremity spasticity. Case Description: A 65-year-old male with intractable epilepsy underwent a right temporal lobectomy for seizure control...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29165784/interventions-for-managing-skeletal-muscle-spasticity-following-traumatic-brain-injury
#17
REVIEW
Anneliese Synnot, Marisa Chau, Veronica Pitt, Denise O'Connor, Russell L Gruen, Jason Wasiak, Ornella Clavisi, Loyal Pattuwage, Kate Phillips
BACKGROUND: Skeletal muscle spasticity is a major physical complication resulting from traumatic brain injury (TBI), which can lead to muscle contracture, joint stiffness, reduced range of movement, broken skin and pain. Treatments for spasticity include a range of pharmacological and non-pharmacological interventions, often used in combination. Management of spasticity following TBI varies from other clinical populations because of the added complexity of behavioural and cognitive issues associated with TBI...
November 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29156545/ultrasonographic-evaluation-of-botulinum-toxin-injection-site-for-the-medial-approach-to-tibialis-posterior-muscle-in-chronic-stroke-patients-with-spastic-equinovarus-foot-an-observational-study
#18
Alessandro Picelli, Alessio Baricich, Elena Chemello, Nicola Smania, Carlo Cisari, Marialuisa Gandolfi, Nicoletta Cinone, Maurizio Ranieri, Andrea Santamato
The tibialis posterior muscle is a frequent target for injection of botulinum toxin during the management of spastic equinovarus foot in adults with post-stroke spasticity. Although it is deep-seated, the needle insertion into the tibialis posterior muscle is usually performed using anatomical landmarks and safety information obtained from healthy subjects and cadavers. Our aim was to evaluate the botulinum toxin injection site for the medial approach to the tibialis posterior muscle in chronic stroke patients with spastic equinovarus foot...
November 18, 2017: Toxins
https://www.readbyqxmd.com/read/29143586/break-out-session-highlights
#19
Kjell-Morten Myhr, Mathias Mäurer, Marisa Martínez Ginés, Federica Esposito, Ralf Linker
A popular feature of the Multiple Sclerosis Experts Summit is interactive break-out sessions to discuss various aspects of multiple sclerosis (MS), including MS spasticity and general management of MS patients. The format encourages participation and active discussion, thus providing attendees with the opportunity to exchange their experiences of the day-to-day management of MS in clinical practice. Following feedback provided by each session leader, key messages are summarized and presented in a plenary session by the Summit chair...
November 2017: Neurodegenerative Disease Management
https://www.readbyqxmd.com/read/29143581/multiple-sclerosis-symptoms-and-spasticity-management-new-data
#20
Guillermo Izquierdo
Spasticity, perceived by patients as muscle rigidity and spasms, is a common symptom in multiple sclerosis (MS). It is associated with functional impairment that can exacerbate other MS symptoms and reduce quality of life. Pharmacological treatment options are limited and frequently ineffective. Treatment adherence is a key issue to address in these patients. The efficacy and safety of 9-delta-tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray for treatment of MS spasticity were demonstrated in four Phase III trials...
November 2017: Neurodegenerative Disease Management
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