Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0026838 (spasticity)
 6,471 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effectiveness of spinal cord stimulation for control of spasticity was studied in 59 spinal cord injury patients. SCS was markedly or moderately effective in reducing spasticity in 63% of the patients. We found that control of spasticity by SCS was not correlated with the severity of spasticity, the type of spasticity (flexor or extensor), or the ability to ambulate. However, stimulation was more effective in patients with incomplete cervical lesions than in complete cervical lesions. Stimulation below the lesion was more effective than above. We conclude that SCS was effective when electrodes were properly positioned below the lesion over the posterior aspect of the spinal cord in patients with some residual spinal cord function. We hypothesize that SCS controls spasticity by modification of activity of spinal-brainstem-spinal loops and by suppression of segmental excitation through antidromic activation of propriospinal pathways.
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PMID:Spinal cord stimulation for the control of spasticity in patients with chronic spinal cord injury: I. Clinical observations. 349 Mar 12

We sought neurophysiologic evidence that spinal cord stimulation could modify the behavior of spinal reflexes in 15 chronic SCI patients who showed the beneficial effect of SCS on spasticity. We studied the behavior of passive stretch, clonus, cutaneous touch, plantar reflex irradiation, and the response to the neck flexion reinforcement maneuver during spinal cord stimulation by use of surface PEMG recordings. Fifty-five percent of the responses were changed during spinal cord stimulation, but with widely varying patterns of response in individual patients. Exceptional patients showed changes in most or all responses; most showed changes in two or three. Thirty of seventy-five responses showed a reduction in motor unit activity in the recordings. Eleven of seventy-five responses were increased. Excessive stimulation strength enhanced spasticity in patients in whom another stimulus setting suppressed spasticity. We conclude that spinal cord stimulation could modify segmental reflexes but that the effects were selective, probably dependent on the preserved segmental structures and ascending and descending pathways.
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PMID:Spinal cord stimulation for the control of spasticity in patients with chronic spinal cord injury: II. Neurophysiologic observations. 349 Mar 13

20 patients with movement disorders and spasticity were treated with SCS to decrease tonus and improve impaired motor function. 12 patients with multiple sclerosis had gait disorders and slight up to considerable increase in tonus. We observed quantitative changes in diminution of spasticity, voluntary motor function, bladder function, lessening of ataxia and pain relief. During a follow-up of up to 4 years no deterioration in the patients' condition could be observed. 11 patients reported a more fluent gait in 6 cases accompanied by a decrease in tonus. Increase in tonus and deterioration of gait pattern were observed after break down of the stimulation. Although the indications for electrostimulation still remains uncertain in some cases with definite diagnosis without any progressive character of the disease and without severe neurological disturbances improvement can be obtained.
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PMID:Application of SCS for movement disorders and spasticity. 349 59

Electrical stimulation of the spinal cord (SCS) to reduce spasticity was evaluated in seven patients who, along with their physicians, perceived significant and prompt benefit from stimulation. In two 24-hour test periods, on or off stimulation, we used two independent methods of evaluation: quantitative measures of joint compliance and stretch reflexes, and a standardized neurologic examination. Neither method did better than chance in determining whether SCS was actually being received. Problems with the experimental protocol are discussed, but the results cannot be interpreted as supporting the efficacy of SCS as a treatment for spasticity.
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PMID:Evaluation of cervical stimulation for chronic treatment of spasticity. 388 12

Neuroaugmentative and neuromodulation therapy continues to expand. New applications are being found for existing technology, such as the use of SCS therapy in the treatment of head pain. The potential impact of existing therapies is enhanced by new discoveries as exemplified by the availability and demonstrated efficacy of different pharmacologic agents and combinations of agents in intrathecal therapy [39]. Increased attention is being paid to cortical stimulation, including motor cortex stimulation and deep brain stimulation. We must, however, not let our fascination for gadgets betray sound sense. The role of psychosocial factors in the outcome of more "objective" and measurable problems, such as spasticity and tremor versus pain, remains an open area of investigation. Although psychologic issues may not be as prevalent in the amelioration of such problems, they may influence the patient's overall level of satisfaction with the therapy and improvement in quality of life.
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PMID:Psychologic evaluation for patients undergoing neuroaugmentative procedures. 1456 42

Non-paresthesia-free spinal cord stimulation (PF-SCS) has been successfully used in treating central pain syndromes in multiple sclerosis (MS) patients. However, the efficacy of PF-SCS in MS is unknown. Here, we present the case of an MS patient (13-year history) with late-stage disease. Her concomitant central pain and spasticity failed multiple attempts of medical management despite escalating multimodal pharmacological regimens. A trial and subsequent permanent placement of dorsal column spinal cord stimulator with paresthesia-free programming was successful in managing her central pain, illustrating a potential role of PF-SCS in treating patients with MS.
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PMID:Successful Treatment of Central Pain and Spasticity in Patient With Multiple Sclerosis With Dorsal Column, Paresthesia-Free Spinal Cord Stimulator: A Case Report. 3104