Author/Editor		Gregorič, Milan
Title		Terapija spastičnosti po možganski kapi
Type		članek
Source		In: Goljar N, Štefančič M, editors. Novosti v rehabilitaciji po možganski kapi. Zbornik predavanj 15. dnevi rehabilitacijske medicine; 2004 mar 26-27; Ljubljana. Ljubljana: Inštitut Republike Slovenije za rehabilitacijo,
Publication year		2004
Volume		str. 223-9
Language		slo
Abstract		Post-stroke spasticity is usually less severe and less disturbing than that in patients with head injuries, spinal cord lesions, multiple sclerosis or cerebral palsy. Prior to introducing therapy it should first be ascertained whether post-stroke spasticity is disturbing at all, how acute it is, how it is distributed (focally, segmentally, diffusely). It is imperative to determine different influences and complications that may enhance the phenomena of spasticity. Taking into consideration the findings of the clinical examination, the therapy objectives are laid down to reduce the tonus of spastically increased muscle tension and improve the extent of locomotion and functional capacities of patients. Another therapy goal to be pursued is a better performance of personal hygiene and body care. The first step is to select physiotherapeutic procedures and various methods of physical medicine (cryotherapy, electrical neuromuscular stimulation). Cases of severely distributed spasticity require peroral administration of medicaments, above all tizanidin (Sirdulad) and baclophen (Lioresal). Disturbing focal spasticity can be treated by injecting phenol along nerves or botulinum into muscles. The beneficial effects of botulinum toxin usually last some months; they can be prolonged and enhanced by additional treatment (physiotherapy, electrical stimulation, braces). Indicated in rare cases of extremely severe, disturbing and widely diffused spasticity defying any other therapy is an attempt to introduce baclophen directly into the spinal channel. If such an attempt is successful, a baclophen pump implant is indicated.
Descriptors		CEREBRAL INFARCTION MUSCLE SPASTICITY ELECTRIC STIMULATION THERAPY BOTULINUM TOXIN TYPE A BACLOFEN