Spasticity: Revisiting the role and the individual value of several pharmacological treatments

Article type: Research Article

Authors: Lapeyre, Eric^a | Kuks, Jan B.M.^b | Meijler, Willem J.^{c; *}

Affiliations: [a] Department of Physical Medicine and Rehabilitation, Hôpital de Percy, Val-de-Grâce, France | [b] Department of Neurology, University Medical Centre Groningen, The Netherlands | [c] Consultant Neurology and Clinical Pharmacology, Groningen, The Netherlands

Correspondence: [*] Address for correspondence: W.J. Meijler, MD, PhD, Hondsruglaan 15, 9722SC Groningen, The Netherlands. Tel.: +31 505 250686; Fax: +31 505 265868; E-mail: w.j.meijler@planet.nl

Abstract: Though in the last few decades only a few new drugs have come available for the treatment of spasticity, new insights may revise the role and individual value of several pharmacological treatments. Diazepam, baclofen and tizanidine are the most prescribed drugs for the treatment of spasticity. Intrathecal baclofen and local infiltration of botulin toxin are added values in selective patients. Gabapentin is a novelty, and the working mechanism of cannabis has been elucidated. Dantrolene sodium appears to owe its selectivity from the recently discovered ryanodine receptor, with a peripheral effect in muscles. In this review the pathophysiology and epidemiology of spasticity, pharmacology, clinical efficacy and unwanted effects of the different drugs for spasticity are updated.

Keywords: Spasticity, review, pharmacology, treatments

DOI: 10.3233/NRE-2010-0596

Journal: NeuroRehabilitation, vol. 27, no. 2, pp. 193-200, 2010